Endocrine therapy (ET) for the treatment of patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR-positive/HER2-negative) metastatic breast cancer (MBC) has changed markedly over recent years with the emergence of new ETs and the use of molecularly targeted agents. Cytotoxic chemotherapy continues, however, to have an important role in these patients and it is important to maximize its efficacy while minimizing toxicity to optimize outcomes. This review examines current HR-positive/HER2-negative MBC clinical guidelines and addresses key questions around the use of chemotherapy in the face of emerging therapeutic options. Specifically, the indications for chemotherapy in patients with HR-positive/HER2-negative MBC and the choice of optimal chemotherapy are discussed.

1st Faculty of Medicine and General Teaching Hospital Charles University Prague Czech Republic

Clinical Cancer Pharmacology and Oncology Leeds Institute of Medical Research University of Leeds and Leeds Teaching Hospitals Trust Leeds

Department of Medicine 1 Division of Oncology Medical University of Vienna Austria

Department of Oncology Kaplan Medical Center Rehovot Israel

Division of Medical Oncology Institute of Oncology Ljubljana Slovenia

ICANS Strasbourg Europe Cancerology Institute Strasbourg France

Loginov Moscow Clinical Scientific Center Moscow Russia

Medical Oncology MHAT Nadezhda Sofia Bulgaria

Medical Oncology Sint Augustinus Hospital Antwerp Belgium

Lancet. 2024 Jul 27;404(10450):339-340. doi: 10.1016/S0140-6736(24)01049-3. PubMed

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