What Comes Next? A Case-Based Approach to Sequencing HR+/HER2–Metastatic Breast Cancer

This activity was originally presented at the 2026 Breast Cancer Day of Education.

In collaboration with HOPA, COA, & Oncology State Societies.

Program Description

Many patients with metastatic hormone receptor–positive (HR+)/HER2– breast cancer receive multiple lines of therapy over several years. The growing availability of CDK4/6 inhibitors, pathway-targeted agents, and antibody-drug conjugates (ADCs) has improved survival outcomes but also introduced considerable complexity in choosing, sequencing, and transitioning therapies after progression. This session expands on sequencing treatment after progression on CDK4/6 inhibitor–based regimens. Participants will follow case-based scenarios that reflect real-world challenges in interpreting HR+/HER2 progression, preserving endocrine options when appropriate, and avoiding reflexive transitions to chemotherapy when endocrine sensitivity persists, with opportunities for interactive responses and discussion with speakers. Discussion will highlight how to apply sequencing logic when multiple actionable alterations are present and how to recognize when transitioning away from endocrine strategies toward ADCs and other non-endocrine options becomes appropriate, including reframing treatment goals in that setting. Speakers will highlight best practices for oncology pharmacists to optimize treatment continuity, minimize avoidable toxicity, and support patients through the complex, multi-line course of treatment in metastatic HR+/HER2– breast cancer.

Target audience: Oncology pharmacists
Type of activity: Application
Release date: July 30, 2026
Expiration date: July 30, 2027
Learner level: Intermediate, Advanced
Time to complete activity: 1.25 hours
Fee: Free

Educational Objectives

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

• Examine a foundational sequencing framework for hormone receptor–positive/HER2− (HR+/HER2−) metastatic breast cancer following progression on CDK4/6 inhibitor–based therapy
• Explain common areas of therapeutic uncertainty in HR+/HER2− metastatic breast cancer and how emerging clinical data influence treatment discussions after progression on CDK4/6 inhibitor–based therapy
• Apply patient-centered counseling approaches to support shared decision-making during treatment transitions in HR+/HER2− metastatic breast cancer

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 1.25 contact hours (0.125 CEU) under the ACPE universal activity number 0290-0000-26-242-H01-P. The activity is available for CE credit through July 30, 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, FHOPA, has the following relevant financial relationships with ineligible companies to disclose:

Consultant: Daiichi Sankyo, Genentech, Pfizer, Regeneron

Megan May, PharmD, BCOP, FHOPA, FAPO, has the following relevant financial relationships with ineligible companies to disclose:

Speakers Bureau: Amgen, AstraZeneca

Pharmacy Times Continuing Education™ Planning Staff—Jim Palatine, RPh, MBA; Rose Buszka, PharmD, BCPS, CHCP; Kylie Ferrentino; and Brianna Winters.

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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