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Use of CDK4/6 inhibitors has changed the landscape for treatment of ER-positive, HER2-negative, metastatic breast cancer. Large randomized clinical trials comparing an endocrine agent with or without one of the three currently available CDK4/6 inhibitors (palbociclib, ribociclib, abemaciclib) in the first-line and second-line setting of ER-positive metastatic breast cancer have consistently shown a significant improvement in progression-free survival with the addition of a CDK4/6 inhibitor. The overall survival advantage has been slower to become evident; clinical trials in different populations of patients with ER-positive metastatic breast cancer have shown statistically significant improvement in overall survival with the addition of abe…