The management of advanced hormone receptor-positive disease has evolved with the emergence of CDK4/6 inhibitors. Improvements in progression-free survival of approximately 10 months were noted in pivotal trials of palbociclib. Strong efficacy was also seen with ribociclib, which was recently approved by the FDA. In the adjuvant treatment setting of hormone receptor-positive disease, an important issue for consideration is the duration of endocrine therapy. Optimizing the treatment of estrogen

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... eceptor (ER)positive breast cancer depends on overcoming resistance to endocrine agents. This tall effort has met with some success with the availability of targeted agents that inhibit cyclin-dependent kinases 4 and 6 (CDK4/6), according to William J. Gradishar, MD, Chair of the NCCN Breast Cancer Panel and Betsy Bramsen Professor of Breast Oncology, . Gradishar focused on the use of targeted agents as additions to endocrine therapy for metastatic breast cancer and the issue of optimal treatment duration of adjuvant endocrine therapy for early-stage breast cancer. Because these have been key topics of panel discussion for several years, the revisions to this year's NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Breast Cancer are more "nuanced" than substantial, he said.