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Metastatic Disease Considerations in HR-Positive Breast Cancer

  • Authors: Erika Hamilton, MD; Seth Wander, MD, PhD; Hope S. Rugo, MD; Jonathan W. Malara, PharmD, BCOP
  • CME / ABIM MOC / CE Released: 11/29/2022
  • Valid for credit through: 11/29/2023, 11:59 PM EST
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Target Audience and Goal Statement

This activity is intended for hematologists/oncologists, pathologists, surgeons, nurse practitioners, physician assistants, pharmacists, and nurses.

The goal of this activity is for the learners to better understand the spectrum of breast cancer treatments in order to develop strategies that can translate data updates into improvements in patient care.

Upon completion of this activity, participants will:

  • Have increased knowledge regarding the
    • Mechanisms of action of endocrine agents
    • Clinical trial data associated with endocrine therapies of consideration for the care of patients with advanced/metastatic HR-positive breast cancer
    • Use of CDK 4/6 inhibitors in advanced/metastatic HR-positive breast cancer
  • Demonstrate greater confidence in their ability to
    • Incorporate endocrine agents into breast cancer care


Medscape, LLC requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.


  • Erika Hamilton, MD

    Director, Breast and Gynecological Cancer Research
    Sarah Cannon Research Institute/Tennessee Oncology
    Nashville, Tennessee


    Erika Hamilton, MD, has the following relevant financial relationships:
    Consultant or advisor for: Arucs; Arvinas; AstraZeneca; Black Diamond; Boehringer Ingelheim; CytomX; Daiichi Sankyo; Santari; Deciphera Pharmaceuticals; Eisai; Genentech; Greenwich LifeSciences; H3 Biomedicine; iTeos; Janssen; Lilly; Loxo; Merck; Mersana; Novartis; Orum Therapeutics; Pfizer; Propella Therapeutics; Roche; Seagen, Inc.; Silverback Therapeutics
    Research funding from: Accutar Biotechnology; AbbVie; Accutar Biotechnology; Acerta Pharma; ADC Therapeutics; AKESOBIO; Amgen; Aravive; ArQule; Artios; Arvinas; AstraZeneca; AtlasMedx; Black Diamond; Bliss BioPharmaceuticals; Boehringer Ingelheim; Cascadian Therapeutics; Clovis; Compugen; Cullen-Florentine; Curis; CytomX; Daiichi Sankyo; Dana Farber Cancer Institute; Dantari; Deciphera; Duality Biologics; eFFECTOR Therapeutics; Ellipses Pharma; Elucida Oncology; EMD Serono; Fochon; Fujifilm; G1 Therapeutics; Genentech; H3 Biomedicine; Harpoon; Hutchinson MediPharma; Immunogen; Immunomedics; Incyte; Infinity Pharmaceuticals; InvestisBio; Jacobio; Karyopharm; Leap Therapeutics; Lilly; Lycera; Mabspace Biosciences; Macrogenics; MedImmune; Merck; Mersana; Merus; Millennium; Molecular Templates; Myraid Genetic Laboratories; Novartis; Nucana; Olema; OncoMed; Onconova Therapeutics; ORIC Pharmaceuticals; Orinove; Pfizer; PharmaMar; Pieris Pharmaceuticals; Pionyr Immunotherapeutics; Plexxikon; Radius Health; Regeneron; Relay Therapeutics; Repertoire Immune Medicine; Rgenix; Roche; Seagen, Inc.; Sermonix Pharmaceuticals; Shattuck Labs; Silverback; StemCentRx; Sutro; Syndax; Syros; Taiho; TapImmune; Tesaro; Tolmar; Torque Therapeutics; Treadwell Therapeutics; Verastem; Vincerx Pharma; Zenith Epigenetics; Zymeworks

  • Jonathan W. Malara, PharmD, BCOP

    Clinical Pharmacy Specialist: Breast Oncology
    The University of Texas MD Anderson Cancer Center
    Houston, Texas


    Jonathan W. Malara, PharmD, BCOP, has no relevant financial relationships.

  • Seth Wander, MD, PhD

    Assistant Professor of Medicine
    Massachusetts General Hospital Cancer Center
    Harvard Medical School
    Boston, Massachusetts


    Seth Wander, MD, PhD, has the following relevant financial relationships:
    Consultant or advisor for: Biovica; Foundation Medicine; Hologic; Lilly; Pfizer; Veracyte (former)
    Research funding from: Genentech; Lilly; Nuvation Bio; Regor Therapeutics

  • Hope S. Rugo, MD

    Professor of Medicine
    Division of Hematology/Oncology
    Breast Oncology and Clinical Trials Education
    University of California, San Francisco
    Comprehensive Cancer Center
    San Francisco, California


    Hope S. Rugo, MD, has the following relevant financial relationships:
    Speaker or member of speakers bureau for: Mylan; NAPO; Puma; Samsung
    Contracted researcher for: AstraZeneca; Ayala; Boehringer Ingelheim; Daiichi Sankyo; Eli Lilly and Company; Gilead; Macrogenics; Merck; Novartis; Pfizer; Polyphor; Roche; Seagen, Inc.; Sermonix


  • Deborah Middleton, MS

    Senior Medical Education Director, Medscape, LLC


    Deborah Middleton, MS, has no relevant financial relationships.

Compliance Reviewer/Nurse Planner

  • Stephanie Corder, ND, RN, CHCP

    Associate Director, Accreditation and Compliance, Medscape, LLC


    Stephanie Corder, ND, RN, CHCP, has no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has no relevant financial relationships.

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  • Medscape, LLC designates this enduring material for a maximum of 1.50 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.50 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Aggregate participant data will be shared with commercial supporters of this activity.

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    For Nurses

  • Awarded 1.50 contact hour(s) of nursing continuing professional development for RNs and APNs; 1.50 contact hours are in the area of pharmacology. 

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  • Medscape, LLC designates this continuing education activity for 1.50 contact hour(s) (0.150 CEUs) (Universal Activity Number JA0007105-0000-22-307-H01-P).

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Metastatic Disease Considerations in HR-Positive Breast Cancer

Authors: Erika Hamilton, MD; Seth Wander, MD, PhD; Hope S. Rugo, MD; Jonathan W. Malara, PharmD, BCOPFaculty and Disclosures

CME / ABIM MOC / CE Released: 11/29/2022

Valid for credit through: 11/29/2023, 11:59 PM EST


Contents of This CME Activity

All sections of this activity are required for credit.

A Remodeled Frontier in Metastatic HR-Positive Breast Cancer

Faculty present clinical data on the use of oral SERDs.
Seth Wander, MD, PhD

A Review of Other Endocrine Agents in Advanced/Metastatic HR-Positive Breast Cancer

Faculty discuss clinical trial data related to SERMs, PROTAC, SERCA, and CERAN.
Erika Hamilton, MD

Advanced/Metastatic HR-Positive Breast Cancer: CDK 4/6 Inhibitors and Beyond

Faculty discuss the efficacy and safety considerations when using CDK 4/6 inhibitors.
Hope S. Rugo, MD; Jonathan W. Malara, PharmD, BCOP

Educational Impact Challenge

The goal of this activity is for the learners to better understand the spectrum of breast cancer treatments in order to develop strategies that can translate data updates into improvements in patient care.

Before you begin this activity, please assess your clinical knowledge by completing this brief survey. Answering these questions again after the activity will allow you to see what you learned and to compare your answers with those of your peers.

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