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**Targeted therapies** are drugs that target specific proteins or pathways that cancer cells need to grow and survive. While hormonal therapy is the primary targeted therapy for ER-positive breast cancer, other targeted therapies may be used in certain situations. **CDK4/6 inhibitors** such as palbociclib, ribociclib, and abemaciclib are often used in combination with hormonal therapy for advanced or metastatic ER-positive, HER2-negative breast cancer. These drugs block proteins called cyclin-dependent kinases 4 and 6 (CDK4/6), which are involved in cell growth and division. By inhibiting these proteins, CDK4/6 inhibitors can help slow down the growth of cancer cells. **PI3K inhibitors**, such as alpelisib, may be used in patients with advanced ER-positive, HER2-negative breast cancer who have a PIK3CA mutation. This mutation is common in breast cancer and can make the cancer cells resistant to hormonal therapy. PI3K inhibitors block the PI3K pathway, which is involved in cell growth and survival. Side effects of targeted therapies can vary depending on the specific drug but may include fatigue, nausea, diarrhea, and changes in blood counts. Targeted therapies are often used in combination with other treatments, such as hormonal therapy or chemotherapy. The decision to use targeted therapy is based on factors such as the stage of the cancer, the presence of specific mutations, and the patient's overall health. Regular monitoring and blood tests are necessary to assess the treatment's effectiveness and manage any potential side effects. Targeted therapies represent a significant advancement in cancer treatment, offering a more precise and personalized approach to targeting cancer cells. They are an important option for patients with advanced or metastatic ER-positive, HER2-negative breast cancer.
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