Wise and skillful utilization of contemporary endocrine therapies for the treatment of ER+/HER2– advanced breast cancer

Endocrine therapy is one of the key and most frequently utilized strategies for breast cancer treatment, both in the early and advanced stages of the disease. Its activity relies on the presence of functional estrogen receptors in cancer cells, which are responsible for stimulating the survival and growth of breast cancer. Over the past four decades, endocrine therapy significantly has progressed not only due to the emergence of new drugs disrupting the estrogen receptor functions but also thanks to the development of new targeted agents that block intracellular mechanisms of hormone resistance. The large number of endocrine therapies used either as monotherapy or in combination with other agents vary not only in their mechanisms of action but also their safety profiles. This diversity poses a big and continuously growing challenge in planning and conducting an optimal, multi-stage palliative hormonal treatment in clinical practice. This article aims to summarize current knowledge on contemporary endocrine treatment options and highlight the possibilities for making hormone therapies a truly personalized treatment for advanced breast cancer patients.