After CDK4/6i in HR+ MBC, the control arm is the story at #ESMO2026.
FINER: fulvestrant alone, median PFS 1.9 mo. Ipatasertib + fulvestrant 5.4 mo, HR 0.68. In AKT pathway-altered tumors, HR 0.55.
FOURLIGHT-1: atirmociclib, a CDK4-selective inhibitor, 9.4 vs 6.6 mo with investigator's choice, HR 0.60. 85 to 92% randomized within 3 months of their last CDK4/6i.
Fulvestrant alone after a CDK4/6i is close to no treatment. FINER helped even without selection, but with toxicity FOURLIGHT-1 tests whether keeping CDK4 pressure on, more selectively, beats switching. #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