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Meta-Analysis Supports Hormone Therapy-Targeted Therapy Combo for Advanced Breast Cancer

Key clinical point: A combination of hormone therapy and a targeted therapy (a CDK4/6 inhibitor, mammalian target of rapamycin inhibitor, or indicated phosphoinositide 3-kinase inhibitor) is the best first- or second-line option for hormone receptor–positive, HER2-negative metastatic breast cancer.

Major finding: Progression-free survival was better with hormone therapy plus targeted therapy versus hormone therapy alone (range of hazard ratios, 0.37-0.48); no chemotherapy regimen, with or without targeted therapy, was superior to hormone therapy plus a CDK4/6 inhibitor.

Study details: A network meta-analysis of 140 randomized, controlled trials among 50,029 patients with hormone receptor–positive, HER2-negative metastatic breast cancer treated in the first- and/or second-line setting.

Disclosures: Dr. Giuliano reported that he receives honoraria from Amgen, AstraZeneca, Celgene, Eisai, Eli Lilly, Novartis, Pfizer,and Roche. The study did not receive any funding.


Giuliano M et al. Lancet Oncol. 2019 Sep 4. doi: 10.1016/S1470-2045(19)30420-6.