Kisqali showed significant efficacy in the treatment of HR+/HER2 breast cancer, but it is necessary to standardize the drug withdrawal process and pay attention to relevant monitoring matters. The following will explain from two aspects: treatment effect evaluation and medication discontinuation precautions.

1. Evaluation of treatment efficacy

(1) When combined with endocrine therapy, the median progression free survival (PFS) can reach over 24 months, significantly better than using endocrine therapy alone.

(2) For patients who have failed previous endocrine therapy, the combination of fluvoxetine can prolong PFS by about 10 months, with an objective response rate of about 40%.

2 Precautions for discontinuation of medication

2.1 Conventional discontinuation indications

(1) Disease progression: Treatment needs to be terminated after imaging confirmation, and other treatment plans should be switched.

(2) Intolerable toxicity: When grade 4 neutropenia or grade 3 or above non hematological toxicity occurs, permanent discontinuation of the medication is required.

2.2 Special Monitoring Requirements

(1) Electrocardiogram monitoring: After discontinuation of medication, continuous monitoring of the QT interval is necessary until the medication is completely cleared (approximately 3 weeks).

(2) Liver function follow-up: For patients with abnormal liver enzymes during treatment, follow-up examinations should be conducted every 2-4 weeks after discontinuation of medication until normal recovery is achieved.

2.3 Reproductive System Management

(1) Women of childbearing age need to continue contraception for 3 weeks after discontinuing medication, while male patients should avoid childbirth within 3 weeks after discontinuing medication.

(2) Breastfeeding is still prohibited for lactating women within 3 weeks after discontinuing medication, and medication clearance should be monitored.