The clinical outcomes for human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (EBC) have been significantly improved since the emergence of HER2-directed therapies.1 Utilizing f-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT), de-escalatio

The monarchE trial was the only adjuvant trial that assessed the benefits of adding 2 years of adjuvant abemaciclib to endocrine therapy (ET) in high-risk hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-), early breast cancer (EBC) patients.¹ This trial randomized 5,637 patients in 1:1 into the abemaciclib + ET group or the ET alone group.¹ In the primary analysis, 2-year abemaciclib demonstrated significant risk reductions in invasive disease-free survival (IDFS) (HR=0.664; 95% CI: 0.578-0.762) and distant relapse-free survival (DRFS) (HR=0.659; 95% CI: 0.567-0.767) in the overall intention-to-treat (ITT) population.¹ In a subsequent subgroup analysis, the dataset was divided into 2 age subgroups, i.e., patients aged <65 years (n=4,787) and ≥65 years (n=850).¹ The median follow-up of monarchE was 42 months

Glossary: BICR: Blinded independent central review; CI: Confidence interval; ECOG: Eastern Cooperation Oncology Group; HER2-: Human epidermal growth factor receptor 2-negative; HR: Hazard ratio; HR+: Hormone receptor-positive; HR-: Hormone receptor-negative; IHC: Immunohistochemistry; ISH: In situ

Glossary: AEs: Adverse events; AI: Aromatase inhibitor; CBR: Clinical benefit rate; CDK4/6i: Cyclin-dependent kinase 4/6 inhibitor; CI: Confidence interval; CR: Complete response; ECOG: Eastern Cooperation Oncology Group; ER+: Estrogen receptor-positive; ET: Endocrine therapy; GnRH: Gonadotropin-r

Glossary: 1L: First-line; ABC: Advanced breast cancer; AE: Adverse event; CBR: Clinical benefit rate; CI: Confidence interval; CKD4/6i: Cyclin-dependent kinase 4/6 inhibotor; HER2-: Human epidermal growth factor receptor 2-negative; HR: Hazard ratio; HR+: Hormone receptor-positive; NR: Not reached

Cancer is a leading cause of death globally, claiming almost 10 million deaths in 2020.¹ Breast cancer is one of the most common cancers in women, with nearly 2.3 million new breast cancer diagnoses in 2020 worldwide.¹ Gene-expression profiling has identified distinct subtypes of cancer, among which there are subpopulations expressing specific markers.² According to the National Institutes of Health (NIH), hormone receptor-positive/human epidermal growth factor 2-negative (HR+/HER2-) is the most prevalent breast cancer.³ Cyclin-dependent kinase 4 and 6 (CDK4/6) are good drug targets for cancer, owing to their role in cell cycle progression.⁴ Ribociclib is one of the 3 inhibitors of CDK4/6 approved in combination with fulvestrant for treating HR+/HER2- advanced breast cancers in adults, based on a series of phase 3 clinical trials called MONALEESA, which tested ribociclib along with different drug partners in HR+/HER2- cancer patients.^4-7 The MONALEESA-2 study showed that progression-free survival (PFS) was significantly longer with first-line ribociclib + letrozole than with placebo + letrozole.⁷ The MONALEESA-7 trial also showed significantly longer median overall survival (mOS) in ribociclib in combination with the endocrine therapy (ET) vs. the placebo arm in postmenopausal HR+/HER2- cancer patients.⁶ Similarly, the primary MONALEESA-3 trial and its subsequent analysis Demonstrated that ribociclib + fulvestrant had significant OS benefit as compared with placebo in HR+/HER2- patients advanced breast cancer patients.^5,6 In a recently held European Society of Medical Oncology (ESMO) Breast Cancer Congress, Neven, et al. presented an updated exploratory mOS analysis result with the longest follow-up of the MONALEESA 3 study to date.⁸

Recently, a group of non-BRCA1/2, moderate- to high-risk breast cancer susceptibility genes, have been observed. Among them, the most prevalent ones are ATM, CHEK2 and PALB2.^1-3 These pathogenic variants (PVs) can increase the risk of breast cancer by at least 2-fold, thus indicating an obvious and urgent need for screening them.^1,3 However, optimal strategies for screening in women carrying these PVs have yet to be well established.¹ In a recent study published in the Journal of the American Medical Association (JAMA), Lowry K P and his colleagues conducted a comparative simulation modeling analysis to determine whether screening using mammography and magnetic resonance imaging (MRI) could benefit breast cancer patients with ATM, CHEK2 and PALB2 PVs at various age intervals, which may increase the survival rate in these female patients.¹

The allostatic load, which results from lifelong exposure to social and environmental stressors such as discrimination and poverty, provides with us a way to evaluate the eftects of chronic stress on a patient's physiology.¹ Chronic stress has been shown to be associated with various health problems, including hypertension, kidney disease, inflammation, and other conditions.¹ According to a recent ECOG-ACRIN E5103 phase 3 clinical trial, Dr. Samilia Obeng-Gysai, a surgical oncologist at The Ohio State University Comprehensive Cancer Center, analyzed the data from the trial on the relationship between allostatic load and clinical outcomes in breast cancer patients, the elevated allostatic load was found to be linked with a lover likelihood of chemotherapy completion and a higher risk of death among breast cancer patients.¹

Breast cancer is the most common cancer among females in Hong Kong and accounted for 27.2% and 12.4% of all cancer incidences and deaths in 2018, respectively.1 Over the past decade, the incidence and death rate of breast cancer continued to increase while the challenges of managing the disease rema