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Droste et al. J Cancer Metastasis Treat 2023;9:2 Journal of Cancer
DOI: 10.20517/2394-4722.2022.94
Metastasis and Treatment

Review Open Access

Endocrine therapy in metastatic breast cancer-more
than just CDK4/6 inhibitors

Annika Droste, Marcus Schmidt

Department of Obstetrics and Gynecology, University Medical Center Mainz, Mainz 55131, Germany.
Correspondence to: Marcus Schmidt, Department of Obstetrics and Gynecology, University Medical Center Mainz,
Langenbeckstr 1, Mainz 55131, Germany. E-mail: marcus.schmidt@unimedizin-mainz.de

How to cite this article: Droste A, Schmidt M. Endocrine therapy in metastatic breast cancer-more than just CDK4/6 inhibitors.
J Cancer Metastasis Treat 2023;9:2. https://dx.doi.org/10.20517/2394-4722.2022.94

Received: 29 Jul 2022 First Decision: 1 Sep 2022 Revised: 29 Oct 2022 Accepted: 1 Feb 2023 Published: 17 Feb 2023

Academic Editors: William P. Schiemann, Christos A. Papadimitriou, Pravin Potdar Copy Editor: Fangling Lan Production Editor:
Fangling Lan

Abstract
Advanced hormone receptor-positive breast cancer is one of the women’s most common malignant diseases and
remains incurable despite recent therapeutic innovations. The dependence of hormone receptor-positive breast
cancer on hormonal growth signals offers the possibility of inhibiting this signaling pathway using anti-hormonal
therapy. Nevertheless, the development of resistance to antitumoral drugs remains a challenge. Molecularly-
targeted substances significantly improve survival rates and (as in the case of cyclin-dependent kinase 4 and 6
inhibitors) are widely used in clinical practice and enhance endocrine therapy’s efficacy. Agents such as
everolimus, alpelisib, and capivasertib target the phosphoinositide 3 kinase/protein kinase B/mammalian target of
rapamycin pathway, which is a promising approach to overcoming endocrine resistance. Novel therapies are being
studied in numerous trials, and some already show significant benefits in survival rates. The development of new
therapies to avert endocrine resistance is an urgent challenge in modern medicine. The following review will
examine some promising therapeutic approaches.

Keywords: Advanced hormone receptor-positive breast cancer, endocrine resistance, CDK4/6 inhibitor,
molecularly-targeted substances

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
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