Long-term data and molecular monitoring are reshaping treatment for hormone receptor–positive breast cancer, with a stronger focus on personalized and proactive care.
Results from the NATALEE trial show that adding ribociclib to endocrine therapy reduces recurrence in early-stage disease. At four years, invasive disease-free survival was 88.5% with ribociclib versus 83.6% without, and the benefit continued after treatment ended.
The SERENA-6 trial highlights a shift to earlier intervention using circulating tumor DNA to detect ESR1 mutations before visible progression. Patients who switched early to camizestrant plus a CDK4/6 inhibitor achieved 16.6 months progression-free survival versus 9.2 months with standard care. Meanwhile, oral SERDs like elacestrant may benefit more patients when combined with targeted therapies.