Key topics included: 

• Defining recurrence risk in high- vs low-risk groups 
• Review of current treatment guidelines 
• Ongoing clinical trials evaluating oral SERDs in the adjuvant early breast cancer setting 

Clinical takeaways

• Risk assessment enables personalized treatment approaches, optimizing therapeutic outcomes  
• High-risk patients exhibit significantly lower invasive disease-free survival than intermediate/low-risk groups, underscoring the need for enhanced treatment strategies 
• Adjuvant ET intensification with CDK4/6 inhibitors has shown clinical benefit; however, emerging resistance remains a challenge, contributing to disease recurrence  
• Oral SERDs have shown evidence of superior efficacy over SOC in metastatic settings, particularly in the presence of ESR1-mut and are now being explored in early-stage disease as either an upfront or switch treatment strategy  
• Elacestrant is the only oral SERD with agonistic properties being investigated as a switch strategy in a “pure high-risk population” following demonstration of CCCA rate reduction, substantial Ki-67 suppression, and activity in ESR1 wild-type breast cancer