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][3] - The standard first-line treatment for HR+/HER2- advanced breast cancer patients is the combination of CDK4/6 inhibitors and endocrine therapy, although overall 5-year survival is less than 50% due to resistance [1][3] - The PAM pathway (PI3K/AKT/mTOR) mutations are critical in the resistance of HR+/HER2- advanced breast cancer, and targeting this pathway with inhibitors may reverse resistance and improve tumor control [1][4] Treatment Landscape - The 5-year survival rate for early-stage breast cancer can reach over 90%, but about 30% progress to advanced stages, where the survival rate drops to 20% [3] - Innovative targeted therapies, such as AKT and PI3K inhibitors, are emerging to overcome endocrine resistance, significantly enhancing treatment efficacy compared to standard endocrine therapy [4][6] - Genetic testing for PAM pathway alterations is recommended for patients experiencing early recurrence or metastasis to guide personalized treatment [5][6] Economic Considerations - The treatment costs for HR+/HER2- advanced breast cancer patients post-resistance are high, necessitating a multi-tiered healthcare support system [2][6] - China is exploring models of "basic medical insurance as a safety net, with commercial insurance involvement" to alleviate the financial burden on patients [2][6] - Basic medical insurance has been instrumental in improving access to innovative drugs by negotiating prices and reducing out-of-pocket expenses for patients [6][7] Challenges and Solutions - The accessibility of innovative PAM pathway drugs is hindered by high costs and limited inclusion in insurance coverage [6][8] - Balancing drug pricing and patient accessibility is a significant challenge, as high R&D costs must be recouped without compromising patient access [8] - Strategies to enhance accessibility include incorporating innovative drugs into insurance plans and expanding commercial insurance options to reduce patient financial pressure [8]