Role of Abemaciclib in Primary Breast Cancer: a Narrative Review of MonarchE

Overview

Journal Transl Breast Cancer Res

Publisher AME Publishing Company

Date 2024 May 16

PMID 38751527

Authors

Nobuyuki Takahashi

Chikako Shimizu

Akihiko Shimomura

Masakazu Toi

Affiliations

Soon will be listed here.

Abstract

Estrogen affects cyclin signaling which results in proliferation of breast cancer cells. Breast cancers expressing hormone receptors (known as hormone receptor-positive or HR+ breast cancers) are characterized by dysregulation of cyclin-dependent kinase 4 and 6 (CDK4/6) activity due to overexpression and amplification of genes associated with the cell cycle. Inhibition of CDK4/6, in combination with endocrine therapy (ET), have shown significant clinical efficacy in treating HR+, human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer, leading to global approval of this combination. Abemaciclib is a CDK4/6 inhibitor with higher potency and inhibits a wider range of CDKs compared with other CDK4/6 inhibitors. The MonarchE study is a global, open-label, randomized phase III study of the efficacy of 2-year abemaciclib treatment, together with standard adjuvant ET, in patients who underwent surgery for early-stage HR+, HER2- breast cancer with anatomical or pathological high-risk recurrence features. Preplanned interim analysis of the MonarchE study showed significantly improved invasive disease-free survival (IDFS) and distant relapse-free survival (DRFS) with the use of abemaciclib-ET combination therapy in comparison with ET alone. This review focuses on the emerging results and limitations of the MonarchE study in determining the way forward from the CDK4/6-ET combination treatment in HR+, HER2- early-stage breast cancer.

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