Treatment Sequencing and Patient Adherence With CDK4/6 Inhibitors
ByDanielle Roman, PharmD, BCOP, Jodi Taraba, PharmD, MS, BCOP,Heather Moore, BCOP, CPP, PharmD, Rose DiMarco, PharmD, BCPS, BCOP Panelists discuss how treatment sequencing in early-stage breast cancer requires a stepwise approach, adding one therapy at a time (typically radiation, then hormonal therapy, then CDK4/6 inhibitors, with special considerations for BRCA-positive patients receiving olaparib first), while in metastatic settings the sequencing is more straightforward with first-line CDK4/6 inhibitors plus endocrine therapy, and how patient adherence can be optimized through shared decision-making, detailed toxicity education with graded explanations, frequent health care team touchpoints especially during the challenging first 90 days, and addressing the unique adherence challenges in early-stage patients who are asymptomatic compared to metastatic patients.