The CDK4/6 Inhibitor in HR-positive Advanced Breast Cancer: A Systematic Review and Meta-analysis

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2018 May 17

PMID 29768351

Citations 11

Authors

Wu Ding

Zhian Li

Caiyun Wang

Guodong Ruan

Luping Chen

Chuanjian Tu

Affiliations

Soon will be listed here.

Abstract

Background: Recently, several high-quality clinical randomized controlled trials (RCTs) have identified that cyclin-dependent kinases (CDKs) 4/6 inhibitors obtained a great safety and efficacy, which can be consequently applied as a combination therapy with letrozole or fulvestrant for women who had advanced breast cancer and progressed while receiving endocrine therapy. In this systemic review, we performed a meta-analysis to explore whether CDK4/6 inhibitors had a significantly benefit to treating hormone receptor-positive (HR-positive)/human epidermal growth factor receptor 2 negative (HER2-negative) advanced breast cancer.

Methods: The data for meta-analysis were collected from MEDLINE, EMBASE, and Cochrane Library from January 1980 to December 2017, and eventually 3182 patients from 6 RCTs were included.

Results: The result showed the CDK4/6 inhibitor group had a longer progression-free survival (PFS) (hazard ratio = 0.51; 95% confidence interval [CI], 0.46-0.57, P < .00001), a better objective response (risk rate = 1.53; 95% CI, 1.35-1.74, P < .00001), as well as a better clinical benefit response (risk rate = 1.29; 95% CI, 1.13-1.47, P = .0001). Besides, subgroup analyses of PFS according to stratification factors and other baseline characteristics confirmed a great performance of CDK4/6 inhibitors across the all subgroups. And sensitive analysis showed that all outcomes were stable except Finn 2014 trail.

Conclusion: CDK4/6 inhibitors can significantly prolong the PFS and improve the objective response and clinical benefit response among the patients with HR-positive/ HER2-negative advanced breast cancer.

Citing Articles

Real-world effectiveness of aromatase inhibitors and fulvestrant in HR+/HER2- advanced breast cancer: a snapshot of the last two years before conventional use of CDK 4/6 inhibitors in a Portuguese institution.

Teodoro M, Mayer A, da Costa Miranda A, Nunes H, Alves da Costa F, Lourenco A J Pharm Policy Pract. 2024; 17(1):2296551.

PMID: 38250517 PMC: 10798277. DOI: 10.1080/20523211.2023.2296551.

Efficacy of CDK4/6 inhibitors combined with endocrine therapy in HR+/HER2- breast cancer: an umbrella review.

Pu D, Xu D, Wu Y, Chen H, Shi G, Feng D J Cancer Res Clin Oncol. 2024; 150(1):16.

PMID: 38240835 PMC: 10798922. DOI: 10.1007/s00432-023-05516-1.

Hormonal-Receptors-Positive and HER2-Negative Patients with Metastatic Breast Cancer Treated with First-Line Palbociclib and Hormonal Therapy: Impact of First-Cycle Neutropenia and Dose Reduction on Therapeutic Outcome.

Elnaghi K, Alghanmi H, Elsamany S, Almarzoki F, Elsafty M, Jaffal M Breast J. 2023; 2023:8994954.

PMID: 37664544 PMC: 10473893. DOI: 10.1155/2023/8994954.

The Combination of CDK 4/6 Inhibitors plus Endocrine Treatment versus Endocrine Treatment Alone in Hormone-receptor (HR)-Positive breast Cancer: a Systematic Review and Meta-analysis.

Hermansyah D, Firsty N, Alhudawy M, Nasution R Med Arch. 2022; 76(5):333-342.

PMID: 36545458 PMC: 9760242. DOI: 10.5455/medarh.2022.76.333-342.

A review on the role of cyclin dependent kinases in cancers.

Ghafouri-Fard S, Khoshbakht T, Hussen B, Dong P, Gassler N, Taheri M Cancer Cell Int. 2022; 22(1):325.

PMID: 36266723 PMC: 9583502. DOI: 10.1186/s12935-022-02747-z.

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