在 HR+ MBC 接受 CDK4/6i 治疗后，对照组才是 #ESMO2026 的看点。
FINER：单用 fulvestrant，中位 PFS 为 1.9 个月。Ipatasertib + fulvestrant 为 5.4 个月，HR 0.68。在 AKT 通路改变的肿瘤中，HR 0.55。FOURLIGHT-1：CDK4 选择性抑制剂 atirmociclib 对比研究者选择方案，9.4 对比 6.6 个月，HR 0.60。85% 至 92% 的患者在末次使用 CDK4/6i 后 3 个月内被随机分组。
CDK4/6i 治疗后单用 fulvestrant 几乎等同于不治疗。即使未进行筛选，FINER 仍显示获益；但考虑到毒性问题，FOURLIGHT-1 检验的是：更有选择性地维持 CDK4 抑制，是否优于换药。#bcsm #ESMO26
@myESMO
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Efficacy and safety of atirmociclib (ATI) + fulvestrant (FUL) in patients (pts) with HR+/HER2– advanced/metastatic breast cancer (mBC) who progressed on prior CDK4/6 inhibitor (CDK4/6i) in a randomized phase 2 study (FOURLIGHT-1)
https://esmocongress.esmo.orgFOURLIGHT-1
https://esmocongress.esmo.org#FINER fulvestrant +/- ipatasertib (AKTi) 45% of pts were pathway altered PFS lengthened in ITT HR 0.68 and AKT altered cohorts HR 0.55 93% diarrhea, pretty high G2/3 rates #ESMO26 #ESMOAmbassadors在 X 查看被引用的帖子
- CancercureClinics@CancercureCLIN
@DrBarbiOnc These findings highlight the importance of exploring new treatment strategies for HR+ metastatic breast cancer after CDK4/6 inhibitors. Further research is essential to improve progression-free survival while carefully managing treatment-related side effects. #BCSM #ESMO2026
来源：Mali Barbi, MD MSc | Breast & Gyn Oncologist · x.com