Core Viewpoint - October is Breast Cancer Awareness Month, emphasizing the importance of early prevention, detection, and treatment, particularly for HR-positive, HER2-negative advanced breast cancer patients [1][2]. Group 1: First-Line Treatment - The standard first-line treatment for HR-positive, HER2-negative advanced breast cancer is endocrine therapy combined with CDK4/6 inhibitors, which are crucial for effective tumor suppression [2]. - Endocrine therapy serves as the cornerstone of treatment, even in cases with visceral metastasis, with key drugs including tamoxifen and aromatase inhibitors [2]. - There are currently eight approved CDK4/6 inhibitors in China for HR-positive, HER2-negative breast cancer, including palbociclib and abemaciclib [2]. Group 2: Post-Resistance Strategies - Resistance to endocrine therapy does not signify the end of treatment; patients should undergo evaluations to identify the cause of resistance and find suitable alternative therapies [5]. - New treatment options are being explored, including novel CDK2/4/6 inhibitors like cumosilib, which have shown promising results in clinical trials, significantly extending progression-free survival [6][7]. - The PAM pathway (PI3K/Akt1/mTOR) is another target for therapy, with various inhibitors being developed to counteract its activation, which can lead to treatment resistance [8][9]. Group 3: Emerging Therapies - ESR1 mutations are common in patients treated with aromatase inhibitors and CDK4/6 inhibitors, leading to the development of selective estrogen receptor degraders (SERDs) as a new treatment option [10]. - Biomarkers such as HER2 and TROP2 can help identify patients who may benefit from antibody-drug conjugates (ADCs), providing targeted therapy to improve outcomes [11]. - The ongoing advancements in medical research and new drug developments offer hope for more effective treatments for HR-positive breast cancer patients [12].

Core Insights - Breast cancer is the most common malignant tumor threatening women's health in China, with HR+/HER2- subtype accounting for approximately 70% of diagnosed cases [1][2] - Early diagnosis and treatment significantly improve prognosis for HR+/HER2- breast cancer patients, but 20%-30% of patients face recurrence risks due to late-stage diagnosis [2] - The introduction of CDK4/6 inhibitors has improved the five-year survival rate, yet some advanced breast cancer patients develop resistance to these treatments [2] - PAM pathway gene testing is crucial for patients who develop endocrine therapy resistance, as over 60% of these patients may have PAM pathway mutations [2] - Precision treatment strategies targeting PAM pathway mutations have become mainstream in late-stage breast cancer management, enhancing patient outcomes [2] Industry Developments - There is an increasing number of innovative breast cancer drugs in research and clinical application, providing more treatment options for patients [3] - Cost remains a significant factor in treatment decisions, and there is a strong expectation for new drugs to be included in health insurance coverage to improve patient access [3]