What were the recent changes in the CANMET (Canadian Menopause Treatment) treatment guidelines of 2023?

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The CANMET Treatment Guidelines for 2023 introduced significant updates to the management of hormone-receptor-positive, HER2-negative advanced breast cancer, prioritizing combinations of endocrine therapy with CDK 4/6 inhibitors, such as ribociclib or abemaciclib, as first-line treatment, based on recent studies like 1 and 2. The guidelines now emphasize the importance of sequencing treatment and overcoming resistance patterns, with a focus on the use of CDK 4/6 inhibitors in combination with endocrine therapy, as shown in studies such as 3 and 2. Key changes include:

  • Expanded recommendations for the use of CDK 4/6 inhibitors, such as ribociclib or abemaciclib, in combination with endocrine therapy, as first-line treatment for hormone-receptor-positive, HER2-negative advanced breast cancer, as supported by studies like 1 and 2.
  • Emphasis on the importance of sequencing treatment and overcoming resistance patterns, with a focus on the use of CDK 4/6 inhibitors in combination with endocrine therapy, as shown in studies such as 3 and 2.
  • New guidance on managing side effects, including diarrhea, fatigue, and nausea, associated with CDK 4/6 inhibitors, with specific strategies for mitigation, as reported in studies like 3 and 2.
  • Refined recommendations for patient selection, including consideration of cardiac morbidities and risk factors for QTc prolongation, when choosing between different CDK 4/6 inhibitors, as discussed in 1. These changes reflect emerging research on treatment efficacy and safety profiles, aiming to improve clinical outcomes through more personalized and evidence-based approaches to breast cancer management, as highlighted in studies like 1 and 2.

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