Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy
Yükleniyor...
Dosyalar
Tarih
2023
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
BioMed Central Ltd
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Background: There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based). Methods: A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and ? 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy. Results: The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0–14.0) months in the ET arm of group A, and 5.3 (3.9–6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8–7.7) months in the ET arm of group B, and 5.7 (4.6–6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5–8.0) months in the ET arm of group C and 4.0 (3.5–4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months. Conclusion: Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET. © 2023, The Author(s).
Açıklama
Anahtar Kelimeler
Advanced breast cancer, Cyclin-dependent kinase, Endocrine treatment, Everolimus, Fulvestrant, Hormonotherapy, Palbociclib, Ribociclib, cyclin dependent kinase 4, cyclin dependent kinase 6, cyclin dependent kinase inhibitor, everolimus, fulvestrant, mammalian target of rapamycin, palbociclib, ribociclib, antineoplastic agent, epidermal growth factor receptor 2, everolimus, protein kinase inhibitor, adult, advanced breast cancer, aged, Article, cancer chemotherapy, cancer combination chemotherapy, cancer growth, cancer therapy, controlled study, drug efficacy, drug use, hormonal therapy, human, major clinical study, monotherapy, patient care, physician, progression free survival, retrospective study, survival analysis, treatment duration, breast tumor, disease exacerbation, female, Antineoplastic Combined Chemotherapy Protocols, Breast Neoplasms, Disease Progression, Everolimus, Female, Fulvestrant, Humans, Protein Kinase Inhibitors, Receptor, ErbB-2
Kaynak
BMC Cancer
WoS Q Değeri
Q2
Scopus Q Değeri
Q1
Cilt
23
Sayı
1
