Common reasons for discontinuing endocrine therapy and CDK 4/6 inhibitors
If you have HR+/HER2- metastatic breast cancer (mBC), it’s likely your initial treatment will be endocrine therapy and CDK 4/6 inhibitors. While these treatments are effective in managing HR+/HER2- mBC, some patients may need to stop treatment earlier than planned. Understanding the common reasons for discontinuation can help you navigate challenges and explore options to stay on treatment longer.
Common reasons for discontinuation of CDK 4/6 inhibitors
- Side effects:
- Fatigue, nausea, low blood cell counts, and diarrhea are common side effects of CDK4/6 inhibitors. Menopausal symptoms, such as hot flashes and night sweats, along with joint or muscle pain are side effects of endocrine therapy. While these side effects can often be managed through additional supportive drugs and lifestyle changes, severe or persistent symptoms may lead some patients to stop treatment or switch medications.
- Disease progression:
- Over time, cancer may become resistant to treatment. This means that the treatment is no longer effective in targeting the cancer. If scans show that the cancer is starting to grow or spread, your doctor may recommend switching to another therapy.
- Emotional or psychological implications:
- Cancer and cancer treatment can be emotionally taxing. Depression, anxiety, or burnout may cause patients to reconsider treatment.
- Financial barriers:
- The cost of cancer treatment can be significant. Even with insurance, high out-of-pocket expenses may impact a patient’s decision to continue.
Preventative measures to prevent discontinuation of CDK 4/6 inhibitors
- Proactive symptom management: Reporting side effects early allows your care team to intervene before they get worse. Adjusting the dose, adding supportive medications, or incorporating palliative care can help improve your quality of life during cancer treatment..
- Emotional support: Counseling, support groups, and connecting with others facing similar challenges can provide emotional relief and encouragement. Your care team can help you find options that are available in your community.
- Financial assistance programs: Many pharmaceutical companies and cancer organizations offer financial assistance programs to reduce medication costs.
- Regular monitoring: Frequent follow-ups and imaging can detect treatment resistance early, allowing a timely switch to another therapy if needed.
What happens after discontinuation
If your treatment is no longer tolerable or effective, your oncologist will work with you to determine the best next steps. Options may include:
- Switching to a different CDK 4/6 inhibitor or targeted therapy
- Trying a different form of endocrine therapy
- Exploring clinical trials for the latest advancements in innovative treatments
- Integrating palliative care to manage symptoms and maintain quality of life while continuing to be treated
Next steps: Making decisions about cancer treatment can be challenging and understanding the reasons for potential treatment changes is important. If you’re considering stopping your current treatment, discuss your concerns with your healthcare team. They can help you explore alternatives, manage side effects, and ensure your care plan continues to meet your goals.
Join the Outcomes4Me CDK 4/6 Community and connect directly with other patients navigating treatment on a CDK 4/6 inhibitor.
