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Efficacy of CDK 4/6 Inhibitors and Radiotherapy in Breast Cancer Patients with Brain Metastases

Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) combined with endocrine therapy are the standard of care for HR-positive/HER2-negative advanced breast cancer patients. However, their role in the treatment of brain metastases is currently unclear. We retrospectively evaluate the results of patients...

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Autores principales: Kubeczko, Marcin, Jarząb, Michał, Krzywon, Aleksandra, Gräupner, Donata, Polakiewicz-Gilowska, Anna, Gabryś, Dorota
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10004463/
https://www.ncbi.nlm.nih.gov/pubmed/36902831
http://dx.doi.org/10.3390/jcm12052044
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author Kubeczko, Marcin
Jarząb, Michał
Krzywon, Aleksandra
Gräupner, Donata
Polakiewicz-Gilowska, Anna
Gabryś, Dorota
author_facet Kubeczko, Marcin
Jarząb, Michał
Krzywon, Aleksandra
Gräupner, Donata
Polakiewicz-Gilowska, Anna
Gabryś, Dorota
author_sort Kubeczko, Marcin
collection PubMed
description Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) combined with endocrine therapy are the standard of care for HR-positive/HER2-negative advanced breast cancer patients. However, their role in the treatment of brain metastases is currently unclear. We retrospectively evaluate the results of patients (pts) with advanced breast cancer treated at our institution with CDK4/6i and radiotherapy to the brain. The primary endpoint was progression-free survival (PFS). Secondary endpoints were local control (LC) and severe toxicity. Among 371 pts treated with CDK4/6i, 24 pts (6.5%) received radiotherapy to the brain before (11 pts), during (6 pts), or after (7 pts) CDK4/6i treatment. Sixteen pts received ribociclib, six received palbociclib, and two received abemaciclib. Six- and twelve-month PFS was 76.5% (95% CI: 60.3–96.9) and 49.7% (95% CI: 31.7–77.9), respectively, whereas six- and twelve-month LC was 80.2% (95% CI: 58.7–100) and 68.8% (95% CI: 44.5–100), respectively. With a median follow-up of 9.5 months, no unexpected toxicity was observed. We conclude that treatment with both CDK4/6i and brain radiotherapy is feasible and should not increase the toxicity compared to brain radiotherapy or CDK4/6i alone. However, the small number of individuals treated concurrently limits the conclusions about the combination of both modalities, and the results from ongoing prospective clinical trials are eagerly awaited to understand both the toxicity profile and the clinical response fully.
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spelling pubmed-100044632023-03-11 Efficacy of CDK 4/6 Inhibitors and Radiotherapy in Breast Cancer Patients with Brain Metastases Kubeczko, Marcin Jarząb, Michał Krzywon, Aleksandra Gräupner, Donata Polakiewicz-Gilowska, Anna Gabryś, Dorota J Clin Med Article Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) combined with endocrine therapy are the standard of care for HR-positive/HER2-negative advanced breast cancer patients. However, their role in the treatment of brain metastases is currently unclear. We retrospectively evaluate the results of patients (pts) with advanced breast cancer treated at our institution with CDK4/6i and radiotherapy to the brain. The primary endpoint was progression-free survival (PFS). Secondary endpoints were local control (LC) and severe toxicity. Among 371 pts treated with CDK4/6i, 24 pts (6.5%) received radiotherapy to the brain before (11 pts), during (6 pts), or after (7 pts) CDK4/6i treatment. Sixteen pts received ribociclib, six received palbociclib, and two received abemaciclib. Six- and twelve-month PFS was 76.5% (95% CI: 60.3–96.9) and 49.7% (95% CI: 31.7–77.9), respectively, whereas six- and twelve-month LC was 80.2% (95% CI: 58.7–100) and 68.8% (95% CI: 44.5–100), respectively. With a median follow-up of 9.5 months, no unexpected toxicity was observed. We conclude that treatment with both CDK4/6i and brain radiotherapy is feasible and should not increase the toxicity compared to brain radiotherapy or CDK4/6i alone. However, the small number of individuals treated concurrently limits the conclusions about the combination of both modalities, and the results from ongoing prospective clinical trials are eagerly awaited to understand both the toxicity profile and the clinical response fully. MDPI 2023-03-04 /pmc/articles/PMC10004463/ /pubmed/36902831 http://dx.doi.org/10.3390/jcm12052044 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kubeczko, Marcin
Jarząb, Michał
Krzywon, Aleksandra
Gräupner, Donata
Polakiewicz-Gilowska, Anna
Gabryś, Dorota
Efficacy of CDK 4/6 Inhibitors and Radiotherapy in Breast Cancer Patients with Brain Metastases
title Efficacy of CDK 4/6 Inhibitors and Radiotherapy in Breast Cancer Patients with Brain Metastases
title_full Efficacy of CDK 4/6 Inhibitors and Radiotherapy in Breast Cancer Patients with Brain Metastases
title_fullStr Efficacy of CDK 4/6 Inhibitors and Radiotherapy in Breast Cancer Patients with Brain Metastases
title_full_unstemmed Efficacy of CDK 4/6 Inhibitors and Radiotherapy in Breast Cancer Patients with Brain Metastases
title_short Efficacy of CDK 4/6 Inhibitors and Radiotherapy in Breast Cancer Patients with Brain Metastases
title_sort efficacy of cdk 4/6 inhibitors and radiotherapy in breast cancer patients with brain metastases
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10004463/
https://www.ncbi.nlm.nih.gov/pubmed/36902831
http://dx.doi.org/10.3390/jcm12052044
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