NCCN Update Clarifies Chemotherapy Selection in HR+/HER2- Early Breast Cancer

In this interview with Pharmacy Times, Lee Schwartzberg, MD, FACP, discusses how recent guideline updates are improving treatment decision-making for patients with hormone receptor–positive, HER2-negative (HR+/HER2−) early-stage breast cancer. He explains that this subtype represents nearly 70% of early-stage diagnoses and has historically lacked clear evidence to guide optimal chemotherapy selection. Schwartzberg highlights the role of updated National Comprehensive Cancer Network (NCCN) guidelines, which now incorporate MammaPrint genomic testing to better identify patients who may benefit from anthracycline-based regimens. He reviews data from the FLEX registry, which demonstrated improved invasive disease-free survival among high-risk patients receiving anthracyclines. These findings help distinguish which patients truly benefit from more aggressive therapy versus less intensive options.