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Review
. 2022 Jul 13;29(7):4956-4969.
doi: 10.3390/curroncol29070394.

Appraising Adjuvant Endocrine Therapy in Hormone Receptor Positive HER2-Negative Breast Cancer-A Literature Review

Danilo Giffoni de Mello Morais Mata  1   2 , Carlos Amir Carmona  1   2 , Andrea Eisen  1   2 , Maureen Trudeau  1   2
Affiliations
Review

Appraising Adjuvant Endocrine Therapy in Hormone Receptor Positive HER2-Negative Breast Cancer-A Literature Review

Danilo Giffoni de Mello Morais Mata et al. Curr Oncol. .

Abstract

Background: Approximately 75% of breast cancer (BC) is associated with luminal differentiation expressing endocrine receptors (ER). For ER+ HER2- tumors, adjuvant endocrine therapy (ET) is the cornerstone treatment. Although relapse events steadily continue, the ET benefits translate to dramatically lengthen life expectancy with bearable side-effects. This review of ER+ HER2- female BC outlines suitable adjuvant treatment strategies to help guide clinical decision making around appropriate therapy.

Methods: A literature search was conducted in Embase, Medline, and the Cochrane Libraries, using ER+ HER-, ET BC keywords.

Results: In low-risk patients: five years of ET is the standard option. While Tamoxifen remains the preferred selection for premenopausal women, AI is the choice for postmenopausal patients. In the high-risk category: ET plus/minus OFS with two years of Abemaciclib is recommended. Although extended ET for a total of ten years is an alternative, the optimal AI duration is undetermined; nevertheless an additional two to three years beyond the initial five years may be sufficient. In this postmenopausal group, bisphosphonate is endorsed.

Conclusions: Classifying the risk category assists in deciding the treatment route and its optimal duration. Tailoring the breadth of ET hinges on a wide array of factors to be appraised for each individualized case, including weighing its benefits and harms.

Keywords: HER2-negative; adjuvant cyclin-dependent kinases 4/6 inhibitors; aromatase inhibitors; bisphosphonates; early breast cancer; endocrine therapy; hormone receptor positive; postmenopausal; premenopausal; selective estrogen receptor.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Adjuvant endocrine therapy for premenopausal women with ER+ HER2− breast cancer.
Figure 2
Figure 2
Adjuvant endocrine therapy for postmenopausal women with ER+ HER2− breast cancer.
See this image and copyright information in PMC

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