The Next Frontier: Strategic Sequencing and Biomarker-Driven Therapy in HR+ Metastatic Breast Cancer

This activity was originally presented at the 2026 HOPA Annual Conference in New Orleans, LA.

Program Info

Hormone receptor-positive (HR+) breast cancer accounts for approximately 70% of all breast cancers and has steadily increased in incidence over the past 3 decades. At the same time, real-world data highlight persistent challenges in treatment sequencing after CDK4/6 inhibitor therapy and suboptimal outcomes with later-line chemotherapy, reinforcing the need for more effective, biomarker-driven strategies in HR+ metastatic breast cancer (mBC). This program is designed to equip oncology pharmacists with the skills to apply emerging clinical trial data for PI3Ka and AKT inhibitors, oral selective estrogen receptor degraders, and PROTACs; integrate PIK3CA and ESR1 mutation testing and circulating tumor DNA monitoring into routine workflows; and lead the multidisciplinary care team in shared decision-making around frontline and post-CDK4/6 therapy selection. Through a focused, case-based discussion on proactive toxicity prevention and management, including strategies for hyperglycemia, gastrointestinal and dermatologic events, and ocular toxicities, participants will learn to optimize adherence and safety while tailoring therapy to patient case scenarios with multiple targetable mutations. Panelists will share best practices to prepare oncology pharmacists to drive precision oncology in HR+ mBC, ensuring evidence-based treatment selection, rational treatment sequencing, and patient-centered counseling to maximize clinical benefit.

Target audience: Oncology pharmacists

Type of activity: Application

Release date: April 15, 2026

Expiration date: April 15, 2027

Learner level: Advanced

Time to complete activity: 1.0 hour

Fee: Free

Educational Objectives

At the completion of this activity, participants will be able to:

• Analyze the latest clinical trial data for current and emerging targeted therapies such as selective estrogen receptor degraders, PROTAC inhibitors, PI3Ka inhibitors, and AKT inhibitors in hormone receptor-positive (HR+) metastatic breast cancer, and their implications for treatment sequencing
• Determine how PIK3CA and ESR1 mutation testing in clinical workflows can identify patients eligible for targeted therapies
• Explore the evolving role of circulating tumor DNA monitoring to inform treatment decisions throughout the course of HR+ metastatic breast cancer
• Apply practical, multidisciplinary approaches to anticipate, monitor, and manage treatment-related toxicities while maintaining adherence

Accreditation

Pharmacy Times Continuing Education™ is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 contact hour (0.10 CEU) under the ACPE universal activity number 0290-0000-26-069-H01-P. The activity is available for CE credit through April 15, 2027.

Instructions for Completing the Activity and Receiving CPE Credit

To receive CPE credit, participants must complete the pretest, view the activity in its entirety, complete the posttest, and complete the online activity evaluation. After successful completion of the online activity evaluation, you can submit your credit to CPE Monitor. You may view your credit within 48 hours at www.mycpemonitor.net. All participants must request credit before the activity expiration date. CE credit will not be issued after this date.

Faculty

Danielle Roman, PharmD, BCOP, has the following relevant financial relationships with ineligible companies to disclose:

Consultant: Daiichi Sankyo, Genentech, Pfizer, Regeneron

Rose DiMarco, PharmD, BCPS, BCOP, has the following relevant financial relationships with ineligible companies to disclose:

Consultant: BMS, IO Biotech, Jazz, Lilly, Sanofi, Urogen

Speakers Bureau: Lilly

The following contributors have no relevant financial relationships with ineligible companies to disclose:

Zoe Larned, MD

Melanie A. Sheen, MD

Pharmacy Times Continuing Education™ Planning Staff—Jim Palatine, RPh, MBA; Rose Buszka, PharmD, BCPS, CHCP; Daphne Davis, PharmD, BCOP; Kylie Ferrentino; Susan Pordon; Brianna Winters; and Chloe Taccetta.

Any relevant financial relationships listed for these individuals have been mitigated.

At least one anonymous peer reviewer was used as part of content validation and conflict resolution. The peer reviewer has no relevant financial relationships with ineligible companies to disclose.

Educational Disclaimer

Continuing professional education activities are offered solely for educational purposes and do not constitute any form of professional advice or referral. Discussions concerning drugs, dosages, and procedures may reflect the clinical experience of the author(s) or be derived from the professional literature or other sources and may suggest uses that are investigational in nature and not approved by the labeling or indications. Participants are encouraged to refer to primary references or full prescribing information resources.

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