CDK4/6 inhibitors have emerged as an important treatment option for advanced hormone receptor-positive breast cancer. They work by blocking the activity of proteins called CDK4 and CDK6, which are involved in cell division. By doing this, these inhibitors can prevent cancer cells from growing and dividing.

Several CDK4/6 inhibitors are currently approved for use, including Ribociclib , Palbociclib and Abemaciclib. They are commonly used in combination with hormone therapy as first-line treatment for advanced hormone receptor-positive breast cancer, and have been shown to significantly prolong progression-free survival in this patient population.

It has been observed that certain markers may predict response to treatment, although further research is needed in this area. For example, patients with hormone receptor-positive breast cancer seem to respond better to CDK4/6 inhibitors compared to those with hormone receptor-negative cancer. There is also some evidence to suggest that alterations in certain genes such as PIK3CA could predict resistance to CDK4/6 inhibitors.

Overall, CDK4/6 inhibitors have brought a significant improvement in the management of advanced hormone receptor-positive breast cancer, offering a balance of efficacy and tolerability that can help to optimise patient outcomes.

This course provides an overview of T-DXd reimbursement updates in Taiwan, specifically for HER2+ 2L metastatic breast cancer (mBC) patients and HER2-low, HR- mBC patients under NHIA coverage. It covers policy changes, clinical implications, and eligibility criteria. Additionally, the course highlights T-DXd’s strong efficacy while maintaining a manageable safety profile as an ADC therapy. The session will also explore key adverse event (AE) management strategies, including the prevention and management of nausea and vomiting using three types of antiemetics for high-emetic-risk drugs, and the prevention and management of interstitial lung disease (ILD). The focus will be on proactive monitoring, early intervention, and best practices to optimize patient outcomes.

活動日期：114年06月21日(週六)12:30-17:20(含課前及課後測驗時間)   課程直播過程如有異常請及時洽詢台灣乳房醫學會(02-2523-9118；bcst@ms46.hinet.net)
活動地點：線上直播。
主辦單位：台灣乳房醫學會
指導單位：衛生福利部國民健康署
課程表：課程總表；第二場課表
乳e學院介面操作手冊：請點此下載操作手冊

本堂課程認證學分申請中，如以下：
1.台灣乳房醫學會：5分
2.台灣外科醫學會：1積點
3.台灣醫學會：4.2分
4台灣護理學會：3.6分
5.台灣專科護理師學會：專科護理師2分
6.中華民國醫事放射學會：4.2分
7.中華民國放射線醫學會：1積點
8.中華民國癌症醫學會：腫瘤內科A類3學分、腫瘤外科A類3學分
9.中華民國醫用超音波學會：5分
10.公務人員時數：4小時
11.國民健康署疑異(疑陽)時數：4小時 
12.國民健康署乳篩時數：2小時 (本系列課程共同認列乳篩時數，當年度累積上限為3小時，且共計於年底一併上傳時數，詳細資訊請洽相關單位)
 

備註：
本乳e學院平台系統中「積分登錄期間」係指學員於該時段完成課程，得獲取時數積分認證資格；「課程開放閱讀期間」係指包含報名、預習、複習等課程開放時段，惟複習等僅作為個人學習，並不包含測驗以及積分認證。
若欲取得本堂課時數積分，請務必於「積分登錄期間」註記時間內參與並完成課程。

In hormone receptor-positive (HR+) breast cancer, the tumor immune microenvironment (TIM) is uniquely shaped by estrogen signaling, which not only suppresses immune activity but also fosters a microenvironment conducive to late recurrence. This makes late recurrence a critical issue that must not be underestimated in these patients. 

Estrogen promotes immunosuppressive mechanisms, such as polarizing macrophages toward the M2 subtype and enhancing Tregs and myeloid-derived suppressor cells (MDSCs). Conversely, CDK4/6 inhibitors and endocrine therapies offer a dual benefit: they block estrogen signaling while also reshaping the TIM. CDK4/6 inhibitors, in particular, have shown promise in triggering anti-tumor immunity and reducing recurrence risk. Excitingly, ongoing research is exploring how different CDK4/6 inhibitors uniquely modulate the TIM, potentially paving the way for more precise and effective treatment strategies in HR+ breast cancer.

Sacituzumab Govitecan (SG; Trodelvy) is a targeted therapy designed for adults with hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC) who have received hormone therapy and at least two additional treatments for metastatic disease. It is an antibody-drug conjugate that binds to the Trop-2 antigen, delivering a potent chemotherapy directly to cancer cells6. Clinical trials have demonstrated that SG significantly improves progression-free survival and overall survival compared to traditional chemotherapy in this patient population. This therapy offers a new treatment option for patients with HR+/HER2- MBC, who historically have had limited treatment choices and poor survival outcomes. SG's mechanism of action and clinical efficacy make it a valuable addition to the treatment landscape for this challenging form of breast cancer.

誠摯歡迎各位學員於11月19日(二)18:40登入乳e學院並”加入我的課程+”，收看聆聽講師們分享2024 ESMO治療最新趨勢