Breast cancer (BC) rates are among the highest in cancer incidence and mortality. Most commonly, these patients are erb2 negative and hormone receptor (HR)-positive and thus, receive hormonal therapy as a cornerstone of their treatment in the advanced setting . The majority of these patients respond to hormonal therapy but primary or secondary resistances may be observed. Several resistance mechanisms have been shown to drive the tumor proliferation, growth, cell cycle and progression via upregulation of alternate signaling including EGFR, PI3K, mTOR and CDK4/6 pathways . Thus, multiple options to overcome this resistance were developed; the most commonly recommended options to enhance hormonal therapy in the second line include the addition of either CDK4/6 or mTOR inhibitors . In this era of personalized medicine, one is obliged to take into consideration three parameters that would constitute the outline of this editorial: tumor biology, host biology and patient’s quality of life.
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