2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T6c3,Based on the results from SOLTI-PATRICIA trial (NCT02448420) cohorts A/B, a direct comparison with standard-of-care treatments is needed to evaluate the efficacy and safety of palbociclib, trastuzumab and endocrine therapy (ET) in PAM50-luminal A/B pretreated patients. SOLTI-PATRICIA cohort C is a randomised, multicentre, prospective, open-label, phase II study. Pretreated patients with HER2-positive, HR-positive, and PAM50-Luminal A/B ABC were randomised 1:1 to receive either i) the triplet regimen or ii) trastuzumab-based treatment of physician's choice (TPC). Patients allocated in the TPC arm were eligible for re-randomization upon disease progression, if the inclusion criteria were still met. The primary endpoint was investigator-assessed progression-free survival (PFS) per RECIST 1.1. 264 participants were pre-screened between August 2019-2023, and 73 patients were randomised (including seven re-randomisations). In the TPC arm: 48.5% were treated with trastuzumab plus chemotherapy, 39.4% with T-DM1 and 12.1 % with trastuzumab plus ET. The triplet was associated with a significantly better PFS compared to TPC (stratified hazard ratio=0.52 [95% CI 0.29-0.95]; two-sided p=0.03). PFS rates after 24 months were 24.0% with the triplet and 4.3% in the TPC arm. The overall response rate was 18.9% (95% CI 8.6-35.7) and 7.1% (95% CI 1.2-25.0), respectively. In the triplet arm, grade ≥3 adverse events occurred in 61.5% of patients, with neutropenia being the most frequent (53.9%). No permanent discontinuations due to toxicity were observed. Combining palbociclib, trastuzumab, and ET was safe and improved significantly PFS, compared to TPC in previously treated HER2-positive, PAM50 luminal A/B ABC patients.31:T9dc,Abstract Purpose: Based on the results from SOLTI-PATRICIA trial (NCT02448420) cohorts A/B, a direct comparison with standard-of-care treatments is needed to evaluate the efficacy and safety of palbociclib, trastuzumab, and endocrine therapy (ET) in PAM50 luminal A/B pretreated patients. Patients and Methods: SOLTI-PATRICIA cohort C is a randomized, multicenter, prospective, open-label, phase II study. Pretreated patients with HER2-positive, hormone receptor–positive, and PAM50 luminal A/B advanced breast cancer were randomized 1:1 to receive either i) the triplet regimen or ii) trastuzumab-based treatment of physician’s choice (TPC). Patients allocated in the TPC arm were eligible for re-randomization upon disease progression, if the inclusion criteria were still met. The primary endpoint was investigator-assessed progression-free survival (PFS) per RECIST version 1.1. Results: A total of 264 participants were prescreened from August 2019 to 2023, and 73 patients were randomly assigned (including seven re-randomizations). In the TPC arm, 48.5% were treated with trastuzumab plus chemotherapy, 39.4% with trastuzumab emtansine, and 12.1% with trastuzumab plus ET. The triplet was associated with a significantly better PFS compared with TPC [stratified hazard ratio = 0.52; 95% confidence interval (CI), 0.29–0.95; two-sided P = 0.03]. PFS rates after 24 months were 24.0% with the triplet and 4.3% in the TPC arm. The overall response rate was 18.9% (95% CI, 8.6–35.7) and 7.1% (95% CI, 1.2–25.0), respectively. In the triplet arm, grade ≥3 adverse events occurred in 61.5% of patients, with neutropenia being the most frequent (53.9%). No permanent discontinuations due to toxicity were observed. Conclusions: Combining palbociclib, trastuzumab, and ET was safe and significantly improved PFS, compared with TPC, in previously treated patients with HER2-positive, PAM50 luminal A/B advanced breast cancer. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Endocrine Therapy: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Endocrine Therapy (modality). Clinician-written summaries and actionable practice insights. 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Findings were consistent across IPTW and Bayesian latent confounding analyses.","limitations":"- Retrospective database design cannot fully exclude residual confounding, despite robust analytical methods.\n- Oncotype DX recurrence scores for the physician-directed group are unknown, so prognostic risk may differ systematically between groups.\n- Overall survival is the only endpoint; breast cancer–specific survival and recurrence data are not available in the NCDB.","practice_takeaway":"Genomic testing with Oncotype DX to guide chemotherapy decisions is associated with better survival outcomes than clinicopathologic-based decisions alone, especially in women aged 56 and older with HR+/HER2- early breast cancer. Clinicians should prioritize Oncotype DX testing before deciding on adjuvant chemotherapy in this population."}},{"doi":"10.1016/j.breast.2026.104898","pmid":"42632206","title":"Leveraging endocrine sensitivity in ER-positive DCIS: Neoadjuvant therapy and nonoperative management","journal_title":"The Breast","journal_issn":"0960-9776","published_at":"2026-08-19T00:00:00.000Z","url":"https://doi.org/10.1016/j.breast.2026.104898","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-26T06:19:57.505Z","updated_at":"2026-08-26T06:19:57.505Z","tags":[{"paper_doi":"10.1016/j.breast.2026.104898","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104898","tag_type":"category","value":"Obstetrics & Gynecology","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104898","tag_type":"condition","value":"Ductal Carcinoma In Situ","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104898","tag_type":"condition","value":"ER-Positive Breast Cancer","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104898","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104898","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104898","tag_type":"modality","value":"Aromatase Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104898","tag_type":"modality","value":"Endocrine Therapy","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104898","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104898","tag_type":"study_design","value":"Systematic Review","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104898","tag_type":"warning","value":"Level of evidence assigned as 3 (systematic review of heterogeneous non-RCT early-phase trials); the included studies are not RCTs, so level 1 does not apply despite the systematic review design.","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104898","tag_type":"warning","value":"No total sample size is reported in the abstract or results; the sample_size tag was omitted as it is indeterminable from available text.","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104898","tag_type":"warning","value":"The paper is dated August 2026 and may reference unpublished or ongoing trials (COMET, LORETTA, RECAST, HORNEO01); results from these trials are not yet incorporated into the conclusions.","value_numeric":null}],"summaries":{"what_studied":"This systematic review evaluated neoadjuvant endocrine therapy (NET) in ER-positive DCIS, synthesizing evidence from prospective and retrospective studies on biological outcomes (Ki-67, PR expression) and radiological outcomes (lesion volume reduction).","key_result":"Four early-phase trials showed consistent Ki-67 and PR suppression with NET, and aromatase inhibitors produced measurable radiologic downsizing in some cohorts; however, pathologic complete response was uncommon and occult invasive disease was found at surgery in a subset of cases.","limitations":"- All included trials were early-phase with high heterogeneity, precluding meta-analysis.\n- Short-term surrogate endpoints (Ki-67 suppression, radiologic volume reduction) are unvalidated as predictors of long-term prevention of invasive transformation.\n- Occult invasive disease found at surgery highlights risks of non-operative approaches with current data.","practice_takeaway":"NET in ER-positive DCIS shows biological activity but should not replace surgery — it is best used now as a tool to assess tumor biology. Non-operative endocrine strategies require validation from ongoing trials (COMET, LORETTA, RECAST, HORNEO01) before any clinical adoption."}},{"doi":"10.1016/j.breast.2026.104893","pmid":"42579982","title":"Radiation therapy trends following breast-conserving surgery in early-stage estrogen receptor-positive breast cancer: particularly in older patients more frequently omitted","journal_title":"The Breast","journal_issn":"0960-9776","published_at":"2026-08-05T00:00:00.000Z","url":"https://doi.org/10.1016/j.breast.2026.104893","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-12T13:26:21.840Z","updated_at":"2026-08-12T13:26:21.840Z","tags":[{"paper_doi":"10.1016/j.breast.2026.104893","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104893","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104893","tag_type":"category","value":"Obstetrics & Gynecology","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104893","tag_type":"condition","value":"Breast Cancer","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104893","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104893","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104893","tag_type":"modality","value":"Endocrine Therapy","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104893","tag_type":"modality","value":"Partial Breast Irradiation","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104893","tag_type":"modality","value":"Radiation Therapy","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104893","tag_type":"modality","value":"Whole Breast Radiation Therapy","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104893","tag_type":"sample_size","value":"n=21418","value_numeric":21418},{"paper_doi":"10.1016/j.breast.2026.104893","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104893","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104893","tag_type":"warning","value":"The 3.5% endocrine therapy administration rate is strikingly low for ER+ breast cancer and may reflect a data capture issue, coding limitation, or a specific subgroup definition rather than true clinical practice — interpret with caution.","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104893","tag_type":"warning","value":"The paper is published in 2026 with data through 2024; some referenced trial results (TOP-1) may still be maturing, and the drop in omission rate (2023–2024 vs. 2020–2022) may reflect trial completion rather than a true reversal of trends.","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104893","tag_type":"warning","value":"The study is Netherlands-based (national registry); generalizability to other healthcare systems may be limited.","value_numeric":null}],"summaries":{"what_studied":"Nationwide trends in breast radiation therapy (RT) administration — including omission, whole breast RT (WBRT), and partial breast irradiation (PBI) — after breast-conserving surgery (BCS) in women ≥50 years with early-stage ER+/HER2− breast cancer, from 2014 to 2024 in the Netherlands (n=21,418).","key_result":"RT omission rose sharply over time, especially in older patients (≥70 years): from 4.6% (2014–2016) to 55.3% (2020–2022), then dropping to 33.8% (2023–2024). In younger patients (50–69 years), omission rose modestly from 1.8% to 8.7%. PBI use surged from 4.3% to 51.9%, while WBRT without boost fell from 81.2% to 46.5%. Age was the strongest predictor of RT omission (OR 10.1).","limitations":"- Only 3.5% of patients received endocrine therapy, which is unexpectedly low and may reflect data limitations or selection bias.\n- The spike in RT omission in older patients (2020–2022) is partly attributed to the TOP-1 trial, making it difficult to separate trial-driven from routine clinical practice changes.\n- Study design is descriptive/observational; causality and outcomes (e.g., recurrence rates) are not reported.","practice_takeaway":"RT omission after BCS in early-stage, low-risk ER+ breast cancer is accelerating — particularly in patients ≥70 years, where one in three now skip RT entirely. Clinicians should distinguish between evidence-based de-escalation and premature adoption of trial protocols outside a controlled setting."}},{"doi":"10.1016/j.breast.2026.104887","pmid":"42520573","title":"Evolution of male breast cancer treatment: Results from twenty years of BreastSurgANZ Quality Audit data","journal_title":"The Breast","journal_issn":"0960-9776","published_at":"2026-07-24T00:00:00.000Z","url":"https://doi.org/10.1016/j.breast.2026.104887","source_score":6,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-09T13:24:59.510Z","updated_at":"2026-08-09T13:24:59.510Z","tags":[{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"category","value":"Obstetrics & Gynecology","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"condition","value":"Breast Cancer","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"condition","value":"Male Breast Cancer","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"generic","value":"aromatase inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"generic","value":"tamoxifen","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"modality","value":"Adjuvant Chemotherapy","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"modality","value":"Endocrine Therapy","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"modality","value":"Mastectomy","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"modality","value":"Sentinel Lymph Node Biopsy","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"sample_size","value":"n=258246","value_numeric":258246},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"study_design","value":"Registry-Based Observational Study","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"warning","value":"Male breast cancer numbers (n=1,542 over 20 years) are small relative to females (n=256,704), which may limit detection of modest treatment changes in the male cohort.","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"warning","value":"Reference list entries were not rendered in the source text, so specific citations supporting key claims cannot be verified.","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104887","tag_type":"warning","value":"The study is observational and registry-based; causality cannot be inferred from treatment trend differences between decades.","value_numeric":null}],"summaries":{"what_studied":"This bi-national registry study used the BreastSurgANZ Quality Audit (BQA) database to compare demographic, histological, and treatment data for male vs. female breast cancer patients in Australia and New Zealand over two decades (2003–2012 vs. 2013–2022), covering 258,246 patients (1,542 males, 256,704 females).","key_result":"Male breast cancer treatment was largely static over 20 years — the only significant change was increased sentinel lymph node biopsy (SLNB) uptake (66% vs. 47%, p<0.001). By contrast, female patients saw significant shifts in nearly every treatment domain; adjuvant chemotherapy use fell in females over time (OR 1.10, 95% CI 1.10–1.11, p<0.001 favoring the earlier decade), while it remained stable in males.","limitations":"- BQA relies on surgical teams to record adjuvant therapies, so post-surgical treatments (e.g., chemotherapy referred but not yet started) may be undercounted.\n- Observational design over a wide time span introduces potential unmeasured biases.\n- Male breast cancer numbers are small (n=1,542), limiting statistical power for subgroup analyses.","practice_takeaway":"Male breast cancer treatment in Australia and New Zealand has barely changed over 20 years — SLNB adoption is the main advance, while surgical and adjuvant therapy de-escalation seen in females has not occurred in males. Clinicians should be aware that male patients are managed without sex-specific evidence-based guidelines, and extrapolation from female data may not be appropriate."}},{"doi":"10.1016/j.annonc.2026.05.699","pmid":"42214557","title":"Updated Results of the POSITIVE (Pregnancy Outcome and Safety of Interrupting Therapy for Women with Endocrine Responsive Breast Cancer) Trial","journal_title":"Annals of Oncology","journal_issn":"0923-7534","published_at":"2026-05-29T00:00:00.000Z","url":"https://doi.org/10.1016/j.annonc.2026.05.699","source_score":51,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-14T13:34:48.402Z","updated_at":"2026-06-14T13:34:48.402Z","tags":[{"paper_doi":"10.1016/j.annonc.2026.05.699","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.699","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.699","tag_type":"condition","value":"Early Breast Cancer","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.699","tag_type":"condition","value":"Hormone Receptor-Positive Breast Cancer","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.699","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.699","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.699","tag_type":"modality","value":"Endocrine Therapy","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.699","tag_type":"sample_size","value":"n=518","value_numeric":518},{"paper_doi":"10.1016/j.annonc.2026.05.699","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.699","tag_type":"study_design","value":"Single-Arm Prospective Trial with External Matched Controls","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.699","tag_type":"warning","value":"Median follow-up of 71 months may be insufficient to capture late HR+ recurrences; authors explicitly flag the need for continued follow-up.","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.699","tag_type":"warning","value":"The fertility preservation subgroup comparison (cryopreservation vs. none) is unadjusted and should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.1016/j.annonc.2026.05.699","tag_type":"warning","value":"The trial is single-arm; SOFT/TEXT patients serve as bootstrap-matched external controls, not a true randomized comparator, which limits causal inference.","value_numeric":null}],"summaries":{"what_studied":"The POSITIVE trial evaluated the safety of temporarily interrupting adjuvant endocrine therapy (ET) for up to 2 years in young women (≤42 years, stage I–III HR+ early breast cancer) wishing to attempt pregnancy, after 18–30 months of ET; 518 women enrolled 2014–2019, with this update reporting outcomes at a median follow-up of 71 months.","key_result":"At 5 years, breast cancer-free interval (BCFI) event rates were 12.3% (POSITIVE) vs. 13.2% (SOFT/TEXT matched controls), a difference of −0.9% (95% CI −4.2% to +2.6%); distant recurrence-free interval (DRFI) events were 6.2% vs. 8.3% (−2.1%, 95% CI −4.5% to +0.4%). Among 497 women followed for non-disease outcomes, 76% had ≥1 pregnancy and 69% had ≥1 live birth, yielding 440 offspring.","limitations":"- Single-arm design with external (bootstrap-matched) controls from SOFT/TEXT; no randomized comparator.\n- Unadjusted comparison of fertility preservation subgroups limits conclusions about embryo/oocyte cryopreservation safety.\n- Median follow-up still relatively short given the known risk of late recurrence in HR+ breast cancer.","practice_takeaway":"Clinicians can reassure young women with HR+ early breast cancer that a temporary ET break to attempt pregnancy does not appear to raise the risk of recurrence at ~6 years of follow-up. Longer surveillance remains important given the late-recurrence pattern of HR+ disease."}},{"doi":"10.1016/j.breast.2026.104769","pmid":"42048902","title":"Real-world effectiveness of CDK4/6 inhibitors in older patients with HR+/HER2- advanced breast cancer: a sub-analysis of the multicenter, PALMARES-2 study","journal_title":"The Breast","journal_issn":"0960-9776","published_at":"2026-03-31T00:00:00.000Z","url":"https://doi.org/10.1016/j.breast.2026.104769","source_score":5,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-08T13:23:45.162Z","updated_at":"2026-05-08T13:23:45.162Z","tags":[{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"brand","value":"Ibrance","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"brand","value":"Kisqali","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"brand","value":"Verzenio","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"category","value":"Obstetrics & Gynecology","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"condition","value":"HR+/HER2- Advanced Breast Cancer","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"generic","value":"abemaciclib","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"generic","value":"palbociclib","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"generic","value":"ribociclib","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"modality","value":"CDK4/6 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"modality","value":"Endocrine Therapy","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"sample_size","value":"n=1982","value_numeric":1982},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"study_design","value":"Real-World Evidence / Retrospective-Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"warning","value":"Longer median follow-up in the palbociclib cohort (vs. ribociclib/abemaciclib) is a material confound acknowledged by the authors; CDK4/6i cross-drug comparisons should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"warning","value":"References in the full text are listed as placeholders ([1], [2], etc.) without citation details, limiting verification of supporting evidence.","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"warning","value":"Sex is inferred as female given the breast cancer population; the paper does not explicitly report the proportion of male patients.","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104769","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — this is a real-world observational sub-analysis; no randomized head-to-head comparison of CDK4/6i in older patients exists.","value_numeric":null}],"summaries":{"what_studied":"Real-world effectiveness of first-line endocrine therapy (ET) plus CDK4/6 inhibitors (palbociclib, ribociclib, or abemaciclib) was compared between older (>75 years, n=302) and younger (≤75 years, n=1680) patients with HR+/HER2- advanced breast cancer in the multicenter Italian PALMARES-2 cohort (n=1982; data cut-off Jan 31, 2024).","key_result":"Older patients had significantly better real-world PFS than younger patients (median 34.9 vs. 33.8 months; aHR 0.77, 95% CI 0.67–0.90, p=0.001). In older patients, palbociclib was as effective as abemaciclib and more effective than ribociclib—the opposite of what was seen in younger patients (p for interaction <0.001). Among palbociclib-treated patients, older patients had better rwPFS than younger (median 38.9 vs. 26.6 months; aHR 0.69, 95% CI 0.57–0.84, p<0.001). Despite better rwPFS, older patients had worse OS (median 61.1 vs. 66.6 months; aHR 1.18, p<0.001), likely driven by fewer subsequent treatment lines and competing causes of death.","limitations":"- Observational design with potential residual confounding; no formal geriatric assessment tools (e.g., G8, ADL, IADL) used to quantify frailty beyond age and comorbidities.\n- Longer follow-up in the palbociclib cohort vs. ribociclib/abemaciclib cohorts may bias CDK4/6i comparisons in favor of palbociclib.\n- Imbalance in sample size and baseline features across CDK4/6i sub-cohorts limits cross-drug comparisons.","practice_takeaway":"For HR+/HER2- advanced breast cancer patients older than 75, ET plus CDK4/6i is highly effective—don't withhold it based on age alone. Palbociclib appears equally effective as abemaciclib in this age group and offers better tolerability and fewer drug–drug interactions, making it the preferred CDK4/6i choice for most patients over 75."}},{"doi":"10.1016/j.breast.2026.104696","pmid":"41547594","title":"Optimizing adjuvant endocrine therapy in premenopausal patients with HER2-positive, hormone receptor-positive breast cancer","journal_title":"The Breast","journal_issn":"0960-9776","published_at":"2026-01-18T00:00:00.000Z","url":"https://doi.org/10.1016/j.breast.2026.104696","source_score":5,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-13","doi":"10.1016/j.breast.2026.104696","days":"7","issn":"0960-9776","rank":"8","field":"Clinical Medicine","score":"5","category":"Obstetrics & Gynecology","categories":["Obstetrics & Gynecology"],"_categories":["Obstetrics & Gynecology"]},"pubmed":{"doi":"10.1016/j.breast.2026.104696","title":"Optimizing adjuvant endocrine therapy in premenopausal patients with HER2-positive, hormone receptor-positive breast cancer.","journal":"Breast (Edinburgh, Scotland)","methods":"","results":"","abstract":"","keywords":[],"pubmed_id":"41547594","conclusions":"","publication_date":"2026-01-18T00:00:00"},"crossref":{"DOI":"10.1016/j.breast.2026.104696","URL":"https://doi.org/10.1016/j.breast.2026.104696","ISSN":["0960-9776"],"link":[{"URL":"https://api.elsevier.com/content/article/PII:S0960977626000068?httpAccept=text/xml","content-type":"text/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://api.elsevier.com/content/article/PII:S0960977626000068?httpAccept=text/plain","content-type":"text/plain","content-version":"vor","intended-application":"text-mining"}],"page":"104696","type":"journal-article","issue":null,"score":1,"title":["Optimizing adjuvant endocrine therapy in premenopausal patients with HER2-positive, hormone receptor-positive breast cancer"],"author":[{"given":"Carmine","family":"Valenza","sequence":"first","affiliation":[]},{"given":"Ann H.","family":"Partridge","sequence":"additional","affiliation":[]},{"given":"Meredith M.","family":"Regan","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2026,1]]},"member":"78","prefix":"10.1016","source":"Crossref","volume":null,"created":{"date-time":"2026-01-12T16:26:00Z","timestamp":1768235160000,"date-parts":[[2026,1,12]]},"indexed":{"date-time":"2026-01-17T08:10:46Z","timestamp":1768637446022,"date-parts":[[2026,1,17]]},"license":[{"URL":"https://www.elsevier.com/tdm/userlicense/1.0/","start":{"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000,"date-parts":[[2026,1,1]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://www.elsevier.com/legal/tdmrep-license","start":{"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000,"date-parts":[[2026,1,1]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"http://creativecommons.org/licenses/by-nc-nd/4.0/","start":{"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000,"date-parts":[[2026,1,7]]},"delay-in-days":6,"content-version":"vor"}],"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"https://linkinghub.elsevier.com/retrieve/pii/S0960977626000068"}},"subtitle":[],"assertion":[{"name":"publisher","label":"This article is maintained by","value":"Elsevier"},{"name":"articletitle","label":"Article Title","value":"Optimizing adjuvant endocrine therapy in premenopausal patients with HER2-positive, hormone receptor-positive breast cancer"},{"name":"journaltitle","label":"Journal Title","value":"The Breast"},{"name":"articlelink","label":"CrossRef DOI link to publisher maintained version","value":"https://doi.org/10.1016/j.breast.2026.104696"},{"name":"content_type","label":"Content Type","value":"simple-article"},{"name":"copyright","label":"Copyright","value":"© 2026 The Authors. 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In the TPC arm: 48.5% were treated with trastuzumab plus chemotherapy, 39.4% with T-DM1 and 12.1 % with trastuzumab plus ET. The triplet was associated with a significantly better PFS compared to TPC (stratified hazard ratio=0.52 [95% CI 0.29-0.95]; two-sided p=0.03). PFS rates after 24 months were 24.0% with the triplet and 4.3% in the TPC arm. The overall response rate was 18.9% (95% CI 8.6-35.7) and 7.1% (95% CI 1.2-25.0), respectively. In the triplet arm, grade ≥3 adverse events occurred in 61.5% of patients, with neutropenia being the most frequent (53.9%). No permanent discontinuations due to toxicity were observed.","abstract":"$30","keywords":[],"pubmed_id":"41335375","conclusions":"","publication_date":"2025-12-03T00:00:00"},"crossref":{"DOI":"10.1158/1078-0432.ccr-25-2882","URL":"https://doi.org/10.1158/1078-0432.ccr-25-2882","ISSN":["1078-0432","1557-3265"],"link":[{"URL":"https://aacrjournals.org/clincancerres/article-pdf/doi/10.1158/1078-0432.CCR-25-2882/3708870/ccr-25-2882.pdf","content-type":"application/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https://aacrjournals.org/clincancerres/article-pdf/doi/10.1158/1078-0432.CCR-25-2882/3723636/ccr-25-2882.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https://aacrjournals.org/clincancerres/article-pdf/doi/10.1158/1078-0432.CCR-25-2882/3723636/ccr-25-2882.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"OF1-OF10","type":"journal-article","issue":null,"score":1,"title":["Palbociclib, Trastuzumab, and Endocrine Therapy in Pretreated HER2-Positive and PAM50 Luminal Advanced Breast Cancer: Randomized Phase II, SOLTI-1303 PATRICIA Trial"],"author":[{"given":"Eva","family":"Ciruelos","sequence":"first","affiliation":[{"name":"1SOLTI Cancer Research Group, Barcelona, Spain."},{"name":"2Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain."},{"name":"3HM Hospitales, Madrid, Spain."}]},{"given":"Tomás","family":"Pascual","sequence":"additional","affiliation":[{"name":"1SOLTI Cancer Research Group, Barcelona, Spain."},{"name":"4Medical Oncology, Institute of Cancer and Blood Diseases, Hospital Clinic of Barcelona, Barcelona, Spain."},{"name":"5Translational Genomics and Targeted Therapies in Solid Tumors group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain."},{"name":"6Faculty of Biomedical and Health Sciences, Department of Medicine, Universidad Europea de Madrid, Madrid, Spain."}]},{"given":"Guillermo","family":"Villacampa","sequence":"additional","affiliation":[{"name":"1SOLTI Cancer Research Group, Barcelona, Spain."},{"name":"7Statistics Unit, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain."}]},{"given":"Sonia","family":"Pernas","sequence":"additional","affiliation":[{"name":"1SOLTI Cancer Research Group, Barcelona, Spain."},{"name":"8Medical Oncology Department, Institut Catala d’ Oncologia (ICO)- Institute of Biomedical Research of Bellvitge (IDIBELL), L’Hospitalet del Llobregat, Barcelona, Spain."}]},{"given":"Rodrigo","family":"Sanchez-Bayona","sequence":"additional","affiliation":[{"name":"1SOLTI Cancer Research Group, Barcelona, Spain."},{"name":"2Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain."}]},{"given":"José","family":"Ponce","sequence":"additional","affiliation":[{"name":"9Medical Oncology, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain."},{"name":"10GEICAM Spanish Breast Cancer Group, Madrid, Spain."}]},{"given":"Blanca","family":"Cantos","sequence":"additional","affiliation":[{"name":"11Hospital Universitario Puerta de Hierro, Madrid, Spain."}]},{"given":"Santiago","family":"Escrivá-de-Romaní","sequence":"additional","affiliation":[{"name":"12Medical Oncology Department, Vall d’Hebron University Hospital, and Breast Cancer Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain."}]},{"given":"Antonia","family":"Perelló","sequence":"additional","affiliation":[{"name":"13Medical Oncology Department, Hospital Universitario Son Espases, Palma De Mallorca, Spain."}]},{"given":"Esther","family":"Sanfeliu","sequence":"additional","affiliation":[{"name":"1SOLTI Cancer Research Group, Barcelona, Spain."},{"name":"5Translational Genomics and Targeted Therapies in Solid Tumors group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain."},{"name":"14Pathology Department, Hospital Clínic de Barcelona, Barcelona, Spain."}]},{"given":"Patricia","family":"Galvan","sequence":"additional","affiliation":[{"name":"5Translational Genomics and Targeted Therapies in Solid Tumors group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain."}]},{"given":"Alvaro","family":"Montaño","sequence":"additional","affiliation":[{"name":"15Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Sevilla, Spain."}]},{"given":"Eduardo","family":"Martínez","sequence":"additional","affiliation":[{"name":"16Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain."}]},{"given":"Ana","family":"Lopez","sequence":"additional","affiliation":[{"name":"10GEICAM Spanish Breast Cancer Group, Madrid, Spain."},{"name":"17Complejo Asistencial Universitario de León, León, Spain."}]},{"given":"Mireia","family":"Mele","sequence":"additional","affiliation":[{"name":"18Medical Oncology, Hospital Universitari Sant Joan de Reus, Reus, Spain."}]},{"given":"Juan","family":"de la Haba","sequence":"additional","affiliation":[{"name":"10GEICAM Spanish Breast Cancer Group, Madrid, Spain."},{"name":"19Medical Oncology Department, Hospital Universitario Reina Sofia, Cordoba, Spain."}]},{"given":"Javier","family":"Cortés","sequence":"additional","affiliation":[{"name":"6Faculty of Biomedical and Health Sciences, Department of Medicine, Universidad Europea de Madrid, Madrid, Spain."},{"name":"20International Breast Cancer Center (IBCC), Pangaea Oncology, Quironsalud Group, Barcelona, Spain."},{"name":"21IOB Madrid, Hospital Beata Maria Ana, Madrid, Spain."}]},{"given":"Antonio","family":"Mulero-Sánchez","sequence":"additional","affiliation":[{"name":"1SOLTI Cancer Research Group, Barcelona, Spain."}]},{"given":"Juan M.","family":"Ferrero-Cafiero","sequence":"additional","affiliation":[{"name":"1SOLTI Cancer Research Group, Barcelona, Spain."}]},{"given":"Mafalda","family":"Oliveira","sequence":"additional","affiliation":[{"name":"1SOLTI Cancer Research Group, Barcelona, Spain."},{"name":"12Medical Oncology Department, Vall d’Hebron University Hospital, and Breast Cancer Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain."}]},{"given":"Lorea","family":"Villanueva","sequence":"additional","affiliation":[{"name":"1SOLTI Cancer Research Group, Barcelona, Spain."}]},{"given":"Xavier","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"1SOLTI Cancer Research Group, Barcelona, Spain."},{"name":"22Medical Oncology, IOR - Instituto Oncologico Dr. Rosell, Hospital General de Catalunya, Barcelona, Spain."}]},{"given":"Patricia","family":"Villagrasa","sequence":"additional","affiliation":[{"name":"1SOLTI Cancer Research Group, Barcelona, Spain."},{"name":"23Reveal Genomics, S.L Barcelona, Barcelona, Spain."}]},{"given":"Aleix","family":"Prat","sequence":"additional","affiliation":[{"name":"1SOLTI Cancer Research Group, Barcelona, Spain."},{"name":"4Medical Oncology, Institute of Cancer and Blood Diseases, Hospital Clinic of Barcelona, Barcelona, Spain."},{"name":"5Translational Genomics and Targeted Therapies in Solid Tumors group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain."},{"name":"23Reveal Genomics, S.L Barcelona, Barcelona, Spain."}]}],"funder":[{"id":[{"id":"10.13039/100004319","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100004319","name":"Pfizer","doi-asserted-by":"publisher"}],"issued":{"date-parts":[[2026,1,6]]},"member":"1086","prefix":"10.1158","source":"Crossref","volume":null,"created":{"date-time":"2025-12-03T16:04:32Z","timestamp":1764777872000,"date-parts":[[2025,12,3]]},"indexed":{"date-time":"2026-01-06T16:31:26Z","timestamp":1767717086180,"date-parts":[[2026,1,6]]},"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://aacrjournals.org/clincancerres/article/doi/10.1158/1078-0432.CCR-25-2882/771469/Palbociclib-Trastuzumab-and-Endocrine-Therapy-in"}},"subtitle":[],"deposited":{"date-time":"2026-01-06T16:28:49Z","timestamp":1767716929000,"date-parts":[[2026,1,6]]},"issn-type":[{"type":"print","value":"1078-0432"},{"type":"electronic","value":"1557-3265"}],"published":{"date-parts":[[2026,1,6]]},"publisher":"American Association for Cancer Research (AACR)","reference":null,"short-title":[],"update-policy":"https://doi.org/10.1158/crossmark_policy","content-domain":{"domain":["aacrjournals.org"],"crossmark-restriction":true},"original-title":[],"container-title":["Clinical Cancer Research"],"reference-count":0,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,1,6]]},"references-count":0,"short-container-title":[],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1158/1078-0432.ccr-25-2882","is_oa":false,"title":"Palbociclib, Trastuzumab, and Endocrine Therapy in Pretreated HER2-Positive and PAM50 Luminal Advanced Breast Cancer: Randomized Phase II, SOLTI-1303 PATRICIA Trial","updated":"2026-01-10T04:46:20+00:00","published_date":"2025-12-03","best_oa_location":null}},"created_at":"2026-01-11T11:19:33.869Z","updated_at":"2026-01-17T09:03:27.421Z","tags":[{"paper_doi":"10.1158/1078-0432.ccr-25-2882","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-2882","tag_type":"condition","value":"HER2-Positive Breast Cancer","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-2882","tag_type":"generic","value":"palbociclib","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-2882","tag_type":"generic","value":"trastuzumab","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-2882","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-2882","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-2882","tag_type":"modality","value":"CDK4/6 Inhibitor","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-2882","tag_type":"modality","value":"Endocrine Therapy","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-2882","tag_type":"modality","value":"HER2-Targeted Therapy","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-2882","tag_type":"sample_size","value":"n=73","value_numeric":73},{"paper_doi":"10.1158/1078-0432.ccr-25-2882","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-2882","tag_type":"warning","value":"Comparator arm consisted of heterogeneous regimens (trastuzumab + chemotherapy, T-DM1, or trastuzumab + endocrine therapy).","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-2882","tag_type":"warning","value":"Only investigator-assessed PFS is reported; no OS data provided.","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-2882","tag_type":"warning","value":"Open-label phase II randomized design with small N and re-randomization in the physician’s choice arm may affect interpretation.","value_numeric":null}],"summaries":{"what_studied":"A multicenter, open-label, randomized phase II trial compared palbociclib + trastuzumab + endocrine therapy with trastuzumab-based treatment of physician’s choice in pretreated HER2-positive, HR-positive, PAM50-luminal A/B advanced breast cancer; the primary endpoint was investigator-assessed PFS per RECIST 1.1. From August 2019–2023, 264 were pre-screened and 73 were randomized (including 7 re-randomizations).","key_result":"The triplet improved PFS versus physician’s choice (HR 0.52, 95% CI 0.29–0.95; p=0.03); 24-month PFS rates were 24.0% with the triplet and 4.3% with physician’s choice. ORR was 18.9% (95% CI 8.6–35.7) for the triplet versus 7.1% (95% CI 1.2–25.0), and in the triplet arm grade ≥3 AEs occurred in 61.5% with neutropenia in 53.9% and no permanent discontinuations due to toxicity.","limitations":"Open-label phase II study with a small randomized sample (n=73) and allowance for re-randomization in the physician’s choice arm. The comparator was heterogeneous (trastuzumab + chemotherapy, T-DM1, or trastuzumab + endocrine therapy), and outcomes were investigator-assessed.","practice_takeaway":"In selected pretreated HR+/HER2+ PAM50-luminal A/B advanced breast cancer, adding palbociclib to trastuzumab and endocrine therapy prolonged PFS versus trastuzumab-based options. Expect frequent neutropenia; monitor counts, noting no permanent discontinuations were reported."}}],"initialOffset":8,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Endocrine Therapy"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Endocrine Therapy"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Endocrine Therapy"}}}]]

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