Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy

BMC Cancer

Research

Yakup Ergün¹  Necla Demir²  Özlem Er³  Başak Oyan Uluç³  Taner Korkmaz³  Özde Melisa Celayir³  Özlem Sönmez³  Hatice Yılmaz⁴  Esin Oktay⁴  Hacer Demir⁵  Sema Sezgin Göksu⁶  Metin Kanıtez⁷  Mehmet Ali Nahit Şendur⁸  Ömer Faruk Kuzu⁸  Seda Kahraman⁸  Ferit Aslan⁹  Eda Eylemer Mocan^1,10  Derya Kıvrak Salim^1,11  Esin Avşar^1,11  Serdar Karakaya^1,12  Kerem Okutur^1,13  Atike Pınar Erdoğan^1,14  Ömer Acar^1,14  Ziya Kalkan^1,15  Senar Ebinç^1,15  Merve Keskinkılıç^1,16  Tuğba Yavuzşen^1,16  Erhan Gökmen^1,17  Elvina Almuradova^1,17  İlker Nihat Öktem^1,18  Baran Akagündüz^1,19  Nilgün Yıldırım^2,20  Fatih Teker^2,21  Nuri Karadurmuş^2,22  İsmail Ertürk^2,22  Enes Erul^2,23  Sercan Aksoy^2,23  İbrahim Karadağ^2,24  Mahmut Gümüş^2,25  Buğra Öztosun^2,25  Abdullah Sakin^2,26  Adnan Aydıner^2,27  Nail Paksoy^2,27  Teoman Şakalar^2,28  Elif Şahin^2,29  Mustafa Seyyar^2,29  Fatih Selçukbiricik^3,30  Serkan Menekşe^3,31  Engin Kut^3,31  Abdüssamet Çelebi^3,32  İbrahim Vedat Bayoğlu^3,32  Mehmet Emin Kalender^3,33  Naziyet Köse Baytemür^3,34  İsa Dede^3,35  Özgür Tanrıverdi^3,36  Ali Alkan^3,36  Kubilay Karaboyun^3,37  Mehmet Artaç^3,38  Muzaffer Uğraklı^3,38  Oğuzhan Selvi^3,39  Çağlayan Geredeli^3,39  Burçin Çakan Demirel^4,40  Arzu Yaren^4,40  Burcu Belen Gülbağcı^4,41  İlhan Hacıbekiroğlu^4,41  Ayşe Demirci^4,41  Bülent Çetin^4,42  Erkan Kayıkçıoğlu^4,42  İvo Gökmen^4,43  İrfan Çiçin^4,43  Cengiz Karacin^4,44  Funda Yılmaz^4,44  Mutlu Doğan^4,44  Berna Oksuzoglu^4,44  Mustafa Altınbaş^4,45  Gökşen İnanç İmamoğlu^4,45  Tülay Eren^4,45  Dilek Erdem^4,46  Sema Türker^4,47  Ertuğrul Bayram^4,48  Semra Paydaş^4,48  Abdilkerim Oyman^4,49  Deniz Işık^5,50  Erdinç Nayır^5,51  Olçun Ümit Ünal^5,52  Özlem Özdemir^5,53 

[1] Batman Training and Research Hospital, Batman, Turkey;Department of Medical Oncology, Acıbadem Hospital, Kayseri, Turkey;Department of Medical Oncology, Acıbadem University Maslak Hospital, Istanbul, Turkey;Department of Medical Oncology, Adnan Menderes University, Aydın, Turkey;Department of Medical Oncology, Afyonkarahisar Health Sciences University Hospital, Afyonkarahisar, Turkey;Department of Medical Oncology, Akdeniz University, Antalya, Turkey;Department of Medical Oncology, American Hospital, Istanbul, Turkey;Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey;Department of Medical Oncology, Ankara Medical Park Hospital, Ankara, Turkey;Department of Medical Oncology, Ankara University, Ankara, Turkey;Department of Medical Oncology, Antalya Training and Research Hospital, Antalya, Turkey;Department of Medical Oncology, Atatürk Pulmonary Diseases Hospital, Ankara, Turkey;Department of Medical Oncology, Bahçelievler Memorial Hospital, Istanbul, Turkey;Department of Medical Oncology, Celal Bayar University, Manisa, Turkey;Department of Medical Oncology, Dicle University, Diyarbakır, Turkey;Department of Medical Oncology, Dokuz Eylül University, İzmir, Turkey;Department of Medical Oncology, Ege University, İzmir, Turkey;Department of Medical Oncology, Ersin Arslan Training and Research Hospital, Gaziantep, Turkey;Department of Medical Oncology, Erzincan Binali Yıldırım University, Erzincan, Turkey;Department of Medical Oncology, Fırat University, Elazığ, Turkey;Department of Medical Oncology, Gaziantep University, Gaziantep, Turkey;Department of Medical Oncology, Gülhane Training and Research Hospital, Ankara, Turkey;Department of Medical Oncology, Hacettepe University Instıtue of Oncology, Ankara, Turkey;Department of Medical Oncology, Hitit University Hospital, Çorum, Turkey;Department of Medical Oncology, Istanbul Medeniyet University, Istanbul, Turkey;Department of Medical Oncology, Istanbul Medipol University Bahçelievler Hospital, Istanbul, Turkey;Department of Medical Oncology, Istanbul University Instıtue of Oncology, Istanbul, Turkey;Department of Medical Oncology, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Turkey;Department of Medical Oncology, Kocaeli University, Kocaeli, Turkey;Department of Medical Oncology, Koç University, Istanbul, Turkey;Department of Medical Oncology, Manisa City Hospital, Manisa, Turkey;Department of Medical Oncology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey;Department of Medical Oncology, Meddem Hospital, Isparta, Turkey;Department of Medical Oncology, Memorial Hospital, Ankara, Turkey;Department of Medical Oncology, Mustafa Kemal University, Hatay, Turkey;Department of Medical Oncology, Muğla Sıtkı Koçman University, Muğla, Turkey;Department of Medical Oncology, Namık Kemal University, Tekirdağ, Turkey;Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey;Department of Medical Oncology, Okmeydanı Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey;Department of Medical Oncology, Pamukkale University, Denizli, Turkey;Department of Medical Oncology, Sakarya University, Sakarya, Turkey;Department of Medical Oncology, Süleyman Demirel University Hospital, Isparta, Turkey;Department of Medical Oncology, Trakya University, Edirne, Turkey;Department of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey;Department of Medical Oncology, UHS Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey;Department of Medical Oncology, VM Medical Park Hospital, Samsun, Turkey;Department of Medical Oncology, Zonguldak Hospital, Zonguldak, Turkey;Department of Medical Oncology, Çukurova University, Adana, Turkey;Department of Medical Oncology, Ümraniye Training and Research Hospital, Istanbul, Turkey;Kocaeli Medical Park, Department of Medical Oncology, Kocaeli, Turkey;Mersin Medical Park Hospital, Department of Medical Oncology, Mersin, Turkey;UHS İzmir Tepecik Training and Research Hospital, İzmir, Turkey;İzmir Bozyaka Training and Research Hospital, İzmir, Turkey;

关键词: Advanced breast cancer;    Cyclin-dependent kinase;    Ribociclib;    Palbociclib;    Everolimus;    Fulvestrant;    Endocrine treatment;    Hormonotherapy;   

DOI  :  10.1186/s12885-023-10609-8

 received in 2022-09-15, accepted in 2023-02-03,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThere 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).MethodsA 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.ResultsThe 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.ConclusionPhysicians 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.

【 授权许可】

CC BY   
© The Author(s) 2023. corrected publication 2023

【 图 表 】

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