{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:22:15Z","timestamp":1788326535111,"version":"build-2803163510"},"reference-count":65,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asia-Pac J Clncl Oncology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Breast cancer (BC) is the most prevalent cancer affecting women globally, with Asia accounting for nearly half of all cases. BC represents a major public health issue, particularly in Indonesia, where it is the leading cancer type among women. Indonesia faces high rates of late\u2010stage diagnoses and poor survival outcomes, largely driven by socioeconomic disparities, limitations in healthcare infrastructure, and delays in detection; challenges also encountered across comparable resource\u2010constrained settings. Hormone receptor\u2010positive (HR+)\/human epidermal growth factor receptor 2\u2010negative (HER2\u02d7) advanced breast cancer (ABC) remains challenging to manage due to the lack of curative treatment options. Current therapeutic strategies focus on prolonging survival and enhancing quality of life. In this context, cyclin\u2010dependent kinase (CDK)4\/6 inhibitors have emerged as a major advancement, significantly improving progression\u2010free and overall survival in selected settings when used in combination with endocrine therapy (ET). The CDK4\/6 inhibitors palbociclib, ribociclib, and abemaciclib have shown notable efficacy in Asian populations, despite a higher incidence of hematological toxicities. However, access to these therapies remains limited in Indonesia because they have not yet been incorporated into national treatment guidelines. This review underscores the critical role of CDK4\/6 inhibitors in the treatment of HR+\/HER2\u02d7 ABC, with a particular focus on Indonesian patients. It supports consideration of these agents for inclusion in national clinical guidelines to enhance patient outcomes. Evidence\u2010informed recommendations endorse their use in patients with ET\u2010sensitive tumors and as a potential alternative to chemotherapy in selected aggressive cases involving visceral disease without immediately life\u2010threatening organ dysfunction. Addressing the barriers to early diagnosis and expanding access to advanced therapies is crucial for improving BC management in Indonesia and comparable settings.<\/jats:p>","DOI":"10.1111\/ajco.70168","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T04:51:26Z","timestamp":1788324686000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["CDK4\/6 Inhibitors in the Management of Hormone Receptor\u2010Positive (HR+)\/Human Epidermal Growth Factor Receptor 2\u2010Negative (HER2\u2212) Advanced Breast Cancer in Indonesia: Challenges, Opportunities, and Recommendations"],"prefix":"10.1111","author":[{"given":"Sonar Soni","family":"Panigoro","sequence":"first","affiliation":[{"name":"Department of Surgery Faculty of Medicine Universitas Indonesia  Jakarta Indonesia"},{"name":"Cipto Mangunkusumo National Central Public Hospital  Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel J.","family":"Haryono","sequence":"additional","affiliation":[{"name":"SJH Initiatives  Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prihantono","family":"Prihantono","sequence":"additional","affiliation":[{"name":"Department of Surgery Faculty of Medicine Universitas Hasanuddin  Makassar, South Sulawesi Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dedy","family":"Hermansyah","sequence":"additional","affiliation":[{"name":"Department of Surgery Faculty of Medicine, Universitas Sumatra Utara  Medan, North Sumatra Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumadi Lukman","family":"Anwar","sequence":"additional","affiliation":[{"name":"Department of Surgery Faculty of Medicine Public Health and Nursing Universitas Gadjah Mada  Yogakarta Indonesia"},{"name":"Dr. Sardjito General Hospital  Sleman Yogyakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2148-0202","authenticated-orcid":false,"given":"Yohana","family":"Azhar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hasan Sadikin General Hospital Faculty of Medicine, Universitas Padjadjaran  Bandung West Java Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Febriyanto","family":"Kurniawan","sequence":"additional","affiliation":[{"name":"Department of Surgery Dharmais National Cancer Hospital  Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Putu Anda Tusta","family":"Adiputra","sequence":"additional","affiliation":[{"name":"Department of Surgery Faculty of Medicine Udayana University  Denpasar Bali Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristanto Yuli","family":"Yarso","sequence":"additional","affiliation":[{"name":"Department of Surgery Faculty of Medicine, Sebelas Maret University and Dr. Moerwardi District Hospital  Solo Central Java Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asdi","family":"Wihandono","sequence":"additional","affiliation":[{"name":"Department of Surgery Surabaya and Faculty of Medicine Dr. Soetomo General Academic Hospital Universitas Airlangga  Surabaya East Java Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"International Agency for Research on Cancer \u201cGlobal Cancer Observatory: Cancer Today. 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