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  Indian J Med Microbiol
 

Figure 1: A suggested treatment algorithm for newly diagnosed MBC patients. a: Switching to endocrine therapy after a period of chemotherapy may be considered in this scenario. b: In patients who previously received exemestane in the metastatic settings or within 12 months before relapse, consider other endocrine therapy combinations with everolimus such as either fulvestrant or tamoxifen. c: Consider this combination option, especially in everolimus-naïve patients who previously received exemestane. d: There is insufficient evidence to support the continued use of CDK4/6 inhibitors in patients who progressed while taking an agent from the same class. *Clinical trial participation is encouraged in the first line of therapy or at the time of progression, whenever feasible. MBC: Metastatic breast cancer, AI: Aromatase inhibitor, GnRH: Gonadotropin-releasing hormone, BSO: Bilateral salpingo-oophorectomy, CDK: Cyclin-dependent kinase

Figure 1: A suggested treatment algorithm for newly diagnosed MBC patients. a: Switching to endocrine therapy after a period of chemotherapy may be considered in this scenario. b: In patients who previously received exemestane in the metastatic settings or within 12 months before relapse, consider other endocrine therapy combinations with everolimus such as either fulvestrant or tamoxifen. c: Consider this combination option, especially in everolimus-naïve patients who previously received exemestane. d: There is insufficient evidence to support the continued use of CDK4/6 inhibitors in patients who progressed while taking an agent from the same class. *Clinical trial participation is encouraged in the first line of therapy or at the time of progression, whenever feasible. MBC: Metastatic breast cancer, AI: Aromatase inhibitor, GnRH: Gonadotropin-releasing hormone, BSO: Bilateral salpingo-oophorectomy, CDK: Cyclin-dependent kinase