Tamoxifen: adjuvant Rx for low-risk pre-meno; ↓ recurrence & ↓ mortality; 10 y superior to 5 y (Lancet 2011;378:771 & 2013;381:805)
Aromatase inhib (AI; anastrozole, letrozole, exemestane): adjuvant Rx for post-meno; ↑ OS vs. tam. (Lancet 2015;386:1341); 7 y of Rx ↑ DFS vs. 5 y of Rx (NEJM 2021;385:395)
Adding selective ER degrader (fulvestrant) to AI ↑ OS if mets
Ovarian suppress
LHRH agonists (eg, leuprolide) or oophorectomy: adjuvant Rx for high-risk pre-meno combined with tam. or AI (NEJM 2018;379:122)
Cell prolif
CDK 4/6 inhib (eg, palbociclib, abemaciclib, ribociclib): + AI (1st-line metastatic Rx) or fulvestrant ↑ PFS (& OS for ribociclib) in stage IV vs. AI alone (NEJM 2018;379:1926; JCO 2017;35:3638); + AI for adjuvant (Ann Onc 2021;32:1571)
mTOR inhib (everolimus): + AI (exemestane) ↑ OS in stage IV