Do you prefer fulvestrant over an AI in advanced hormone receptor + breast cancer?

As expected, FALCON was positive for PFS benefit. OS report is awaited. These results give us another option to treat HR+ MBC in first-line setting, along with palbociclib + AI and an AI-alone option. In my personal practice, I use AI-alone in patients with low volume bone-only disease in first line...

One thing to remember is that there is limited data on sequencing endocrine therapy with fulvestrant first, followed by an AI. Because of ER degradation, response to an AI after progression on fulvestrant could theoretically be low.

AI initially is most appropriate, and reserve a CDK 4/6 inhibitor t...