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Fatima CardosoIn her introduction to the symposium, Dr Fatima Cardoso points out that the CDK4&6 inhibitors are one of the hot topics of the moment in breast cancer, and their use is to be discussed, from both the physician’s and the patient’s perspectives, by a very distinguished panel of experts. How much do the symposium’s participants know about these drugs?
Angelo Di LeoDr Angelo Di Leo focuses on preclinical data and the history of CDK4&6 inhibition. Endocrine therapy in breast cancer was first attempted – as radical mastectomy – in 1894; the first oophorectomy was performed in 1896. Then, constant progress in endocrine therapy for ER-positive breast cancer culminated, 50 years ago, in tamoxifen.
Fatima CardosoDr Fatima Cardoso considers the clinical data on the three CDK4&6 inhibitors, abemaciclib, palbociclib, and ribociclib. First to reach the clinic was palbociclib, investigated in the phase 2 PALOMA 1 trial. Patients with ER+/HER2− breast cancer, 45–50% of whom had visceral disease, received letrozole alone or with palbociclib.
Naomi FitzgibbonNaomi Fitzgibbon describes her work in the Irish Cancer Society, an organization that provides support for cancer patients in a variety of ways. Cancer patients have a wide range of needs – physical, practical, and emotional – and they need different information at different times in their cancer journey. Lack of information is associated with uncertainty, anxiety, and depression.
Lesley-Ann MartinDr Lesley-Ann Martin discusses the need for biomarkers to identify patients who may benefit from CDK4&6 inhibition, examines possible combinations and the patients likely to respond to them, and considers other cohorts of patients who may benefit from CDK4&6 inhibition. Response to a CDK4&6 inhibitor requires an intact Rb pathway and, probably, upregulation of cyclin D and low levels of p16.