Managing Precautions and Next Steps After First-Line CDK4/6 Inhibitors

EP: 1.How CDK4/6 Inhibitors Enable More Personalized Treatment in HR+ mBC

EP: 2.CDK4/6 Inhibition Customizes Frontline HR+, HER2- mBC Treatment

EP: 3.Routine Helps Patients With Breast Cancer on CDK4/6 Inhibitors Gain Independence

EP: 4.Encouraging CDK4/6 Adherence Through Emotional Awareness

EP: 5.Common Adverse Events Associated With CDK4/6 Inhibitors

EP: 6.How to Give Subsequent Therapy for Older Patients With Breast Cancer on CDK4/6 Inhibitors

EP: 7.Personalizing CDK4/6 Inhibitor Care to Reduce Adverse Events

EP: 8.CDK4/6 Inhibitors: How to Tailor Treatment Choices by AEs

EP: 9.A Nurse’s Overview of First-Line Treatment for HR+ Metastatic Breast Cancer

EP: 10.CDK4/6 Inhibitor Selection in HR+/HER2– Breast Cancer

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EP: 11.Managing Precautions and Next Steps After First-Line CDK4/6 Inhibitors

When patients with hormone receptor (HR)–positive, HER2-negative metastatic breast cancer experience progression on first-line CDK4/6 inhibitors, treatment decisions can move beyond switching to another agent in the same class, explained Courtney Moore, APRN, FNP-C, OCN, a nurse practitioner at Norton Cancer Institute Medical Oncology and Hematology.

In an interview with Oncology Nursing News conducted after a Case-Based Roundtable discussion on CDK4/6 inhibitor selection in the first-line setting, Moore reflected on conversations around individualizing next steps for patients. She noted that rebiopsy or additional biomarker testing may help guide more personalized therapy, ensuring that treatment decisions are informed by disease biology rather than a generalized approach.

The discussion also touched on proactive symptom management. Some clinicians plan supportive medications, such as antiemetics, before initiating chemotherapy to help patients manage treatment-related toxicities at home. Moore emphasized that this same practice can be applied to CDK4/6 inhibitors—including palbociclib (Ibrance), ribociclib (Kisqali), and abemaciclib (Verzenio)—to support patients in managing potential adverse effects from the outset.

Moore highlighted the importance of tailoring both treatment strategies and supportive care measures to optimize outcomes and quality of life for patients receiving CDK4/6 inhibitors.

Transcript

Towards the end of the event, we were talking about what to do if a patient progresses on their first-line CDK4/6 inhibitor, and 1 of the other nurse practitioners brought up, possibly rebiopsying or taking the original biopsy for further testing to see if there is any other biological markers that we could focus a treatment on to give them a more personalized treatment plan than a generalized CDK4/6 inhibitor.

It brought up a really good discussion on how we take the next step, rather than, “OK, we are going to switch to this CDK4/6 inhibitor instead.” That was a really great conversation.

There was another part where we were talking about adverse effects and toxicities, and 1 of the nurse practitioners brought up, if she’s going to start the patient on a certain CDK4/6 inhibitor, she goes ahead and plans out symptom management medications. In oncology, especially with our chemotherapies, we will send in nausea meds for the patient before they even start their start their treatment, so they have it at home, baseline if they need it.

[We talked about] considering the same thing for the CDK4/6 inhibitors, sending supportive medications with their treatment, that way they have it at home, ready to use if they need it.

This transcript has been edited for clarity and conciseness.