Key points
- There are a number of therapies available for hormone receptor-positive advanced breast cancer.
- Palbociclib is publicly funded in New Zealand.
- Prognostic testing and clinical trials may identify further avenues for treatment.
CDK4/6 inhibitors
This treatment is a small molecule that targets cyclin-dependent kinases (CDK4/6). These are proteins that inhibit cell proliferation and help mediate endocrine resistance.
Palbociclib (Ibrance)
Palbociclib is indicated for use in post-menopausal women with estrogen receptor positive (ER+), HER2- locally advanced or metastatic breast cancer. It is given in conjunction with an aromatase inhibitor. In women who have had prior endocrine therapy it is given with fulvestrant. This therapy is delivered as a tablet, taken once a day for three weeks, followed by a week for recovery before starting again. Palbociclib has been publicly funded in New Zealand since April 2020.
KISQALI (ribociclib, formerly called LEE011)
KISQALI can be used in combination with an aromatase inhibitor as initial therapy to treat advanced HR+(?), HER2-negative breast cancer in postmenopausal women. KISQALI is a tablet, taken orally. It is not registered for use or funded in New Zealand.
Abemaciclib (Verzenio)
Abemaciclib stops the proliferation of cancer cells in HR+, HER2- locally advanced or metastatic breast cancer. While it is registered in other countries as a first and second-line treatment, it is not registered in New Zealand.
Other targeted therapies
Everolimus (Afinitor)
Everolimus belongs to a class of drugs known as mTOR inhibitors, which target the mTOR proteins that fuel cancer cell growth and division. It can be used in post-menopausal women with metastatic HR+, HER2- breast cancer, in conjunction with exemestane (Aromasin), but only if the patient has previously been treated with AIs. It is taken as a daily tablet. It is not funded in New Zealand.
