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AZD4547 + anastrozole + letrozole is a combination therapy investigated for the treatment of estrogen receptor-positive (ER+) metastatic breast cancer, particularly in patients who have developed resistance to aromatase inhibitors. AZD4547 (also known as fexagratinib) is a potent and selective small molecule inhibitor of fibroblast growth factor receptor (FGFR) 1, 2, and 3 tyrosine kinases. Anastrozole and letrozole are non-steroidal aromatase inhibitors that block the conversion of androgens to estrogens, thereby reducing estrogen levels and limiting the growth stimulus for ER+ breast cancer cells. The rationale for combining these agents is based on evidence that FGFR pathway activation can mediate resistance to endocrine therapies; thus, dual targeting may overcome or delay this resistance. Clinical studies such as the RADICAL trial have evaluated this combination's safety and efficacy in advanced ER+ breast cancer patients resistant to aromatase inhibitors[4][5][6].
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