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Case Challenge: Optimizing Adjuvant Therapy for a 39-Year-Old Premenopausal Woman With High-Risk HR-Positive/HER2-Negative Early Breast Cancer

Case Challenge
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This activity is available for 0.50 CME/CE credit(s).

Released: August 31, 2026

Expiration: February 28, 2027

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CDK4/6 inhibitors are essential to the optimal adjuvant treatment of high-risk HR-positive/HER2-negative early breast cancer. However, challenges remain in identifying patients eligible for this treatment. In this interactive case challenge, you will walk through a patient case and make clinical decisions to optimize care for a patient with high-risk HR-positive/HER2-negative early breast cancer. Topics include understanding eligibility criteria for adjuvant CDK4/6 inhibitors, strategies for counseling patients about monitoring requirements and treatment goals, optimal dosing, and adverse event management to promote treatment persistence.

CDK4/6i Selection

Pre Assessment

Assess your current knowledge and clinical approach before beginning your Case Challenge.
1.

How many people with breast cancer do you provide care for in a typical month?

2.

For those who practice in academic or community settings, please indicate your practice setting:

3.

A 42-year-old premenopausal woman with pT2N1a, grade 3, invasive ductal carcinoma (IDC) that is hormone receptor (HR) positive/HER2-negative has completed adjuvant chemotherapy and presents to your clinic to discuss additional recommended adjuvant systemic therapy.

In addition to adjuvant ovarian function suppression (OFS) and aromatase inhibitor (AI), which of the following would be the most appropriate additional adjuvant systemic therapy to recommend for her?

4.

A patient with high-risk HR-positive/HER2-negative EBC requires a dose reduction of adjuvant abemaciclib because of grade 3 liver function test (LFT) elevations. She asks whether reducing the dose will make the treatment less effective.

What would you say while counseling this patient?