4.5 Review

Recent Developments in the Therapeutic Landscape of Advanced or Metastatic Hormone Receptor-Positive Breast Cancer

Journal

CANCER RESEARCH AND TREATMENT
Volume 55, Issue 4, Pages 1065-1076

Publisher

KOREAN CANCER ASSOCIATION
DOI: 10.4143/crt.2023.846

Keywords

Breast neoplasms; Endocrine therapy; Hormone receptor positive; CDK4/6 inhibitor

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Hormone receptor-positive (HR+) breast cancer is the most common subtype with a favorable prognosis. Endocrine therapy, targeting steroid hormone signaling, is the main treatment option. The discovery of cyclin-dependent kinase 4/6 inhibitors has greatly improved the treatment outcome of advanced HR+ breast cancer. Additionally, targeted therapy, inhibitors, antibody-drug conjugates, and immunotherapeutic agents have expanded the available therapeutic options.
Hormone receptor-positive (HR+) disease is the most frequently diagnosed subtype of breast cancer. Among tumor subtypes, natural course of HR+ breast cancer is indolent with favorable prognosis compared to other subtypes such as human epidermal growth factor protein 2-positive disease and triple-negative disease. HR+ tumors are dependent on steroid hormone signaling and endocrine therapy is the main treatment option. Recently, the discovery of cyclin-dependent kinase 4/6 inhibitors and their synergistic effects with endocrine therapy has dramatically improved treatment outcome of advanced HR+ breast cancer. The demonstrated efficacy of additional nonhormonal agents, such as targeted therapy against mammalian target of rapamycin and phosphatidylinositol 3-kinase signaling, poly(ADP-ribose) polymerase inhibitors, antibody-drug conjugates, and immunotherapeutic agents have further expanded the available therapeutic options. This article reviews the latest advancements in the treatment of HR+ breast cancer, and in doing so discusses not only the development of currently available treatment regimens but also emerging therapies that invite future research opportunities in the field.

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