Dysregulated cellular proliferation represents a hallmark feature across all cancers. Aberrant activation of the cyclin-dependent kinase 4 and 6 (CDK4/6) pathway, independent of mitogenic signaling, engenders uncontrolled breast cancer cell proliferation. Consequently, the advent of CDK4/6 inhibition has constituted a pivotal milestone in the realm of targeted breast cancer therapy. The combination of CDK4/6 inhibitors (CDK4/6i) with endocrine therapy (ET) has emerged as the foremost therapeutic modality for patients afflicted with hormone receptor-positive (HR + )/HER2-negative (HER2-) advanced breast cancer. At present, the Food and Drug Administration (FDA) has sanctioned various CDK4/6i for employment as the primary treatment regimen in HR + /HER2- breast cancer. This therapeutic approach has demonstrated a substantial extension of progression-free survival (PFS), often amounting to several months, when administered alongside endocrine therapy. Within this comprehensive review, we systematically evaluate the utilization strategies of CDK4/6i across various subpopulations of breast cancer and explore potential therapeutic avenues following disease progression during application of CDK4/6i therapy.

Objectives: The incidence of peripheral arterial disease (PAD) in China is increasing. We aim to conduct a comprehensive analysis of the burden of PAD.Methods: We collected information from 1990 to 2019 in the Global Burden of Disease (GBD 2019) study. Joinpoint regression analysis was used to calculate the annual percentage change (APC). Trends in incidence, mortality and DALYs were forecasted by Bayesian age-period-cohort (BAPC) analysis.Results: In 2019, the number of new cases and prevalence of PAD in China accounted for nearly a quarter of the global proportion. The age-standardized incidence rate (ASIR) declined after rising until 2005. The age-standardized death rate (ASDR) maintained an upward trend. The DALYs was 0.16 million. Incidence, prevalence and DALYs are predominantly female, except for mortality, which is predominantly male. Smoking predominantly affected males, while hypertension and diabetes had a greater impact on females. By 2030, ASDR is elevated, predominantly in males. ASIR and age-standardized DALY rate decline, predominantly in females.Conclusion: It is urgent for China to develop strategies based on the specific distribution characteristics of the PAD burden.

Endocrine therapy (ET) is a cornerstone in adjuvant therapy for hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative (HER2−) breast cancer. However, recent research challenges the conventional 5-year adjuvant therapy duration. Patients with T1N0M0 HR+/HER2− breast cancer face a 13% risk of distant recurrence after 5 years of endocrine treatment. This risk increases to 34% over two decades for patients with 4–9 lymph node metastases. Thus, it is important to consider supplementary treatments for T1N0M0 HR+/HER2− breast cancer patients, particularly those with additional high-risk features such as young age, high tumor grade, or adverse genomic profile. We summarize intensive treatment methods for T1N0M0 HR+/HER2− breast cancer patients, which extend beyond the standard 5-year tamoxifen (TAM)-based adjuvant ET. These methods include intensive ET, poly(ADP-ribose) polymerase (PARP) inhibitors, other targeted therapies, antibody-drug conjugates, oral chemotherapy, immunotherapy, and enhanced prevention of bone metastasis. This review provides a foundation for developing personalized adjuvant treatment strategies for patients with T1N0M0 HR+/HER2− breast cancer.

The advent of immunotherapy, and particularly the development of immune checkpoint inhibitors (ICIs), has revolutionized the landscape of breast cancer treatment, especially for triple-negative breast cancer. However, some patients still do not benefit from immunotherapy. Breast cancer is inherently an immunotherapy “cold” tumor, which results in suboptimal clinical outcomes when ICIs are used as monotherapy. Identifying additional immunotherapeutic targets and drugs, along with developing novel strategies for combination therapy, is crucial for addressing the challenges posed by immunotherapy resistance and tumor immune escape driven by multiple mechanisms. For instance, the combination of the programmed cell death protein 1 inhibitor, pembrolizumab, with chemotherapy has demonstrated remarkable clinical efficacy and is now the preferred first-line treatment for neoadjuvant, adjuvant, and metastatic breast cancer. This review discusses recently developed ICIs and focuses on strategies combining ICIs with chemotherapy, targeted therapy, nanotherapy, and other approaches in breast cancer. This review aims to summarize recent advances in immune checkpoint inhibitor-based combination strategies in breast cancer and to provide insights into improving therapeutic efficacy, overcoming treatment resistance, and ultimately enhancing patient outcomes.