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Comparison of the Effectiveness and Clinical Outcome of Everolimus Followed by CDK4/6 Inhibitors with the Opposite Treatment Sequence in Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer

PURPOSE: In hormone receptor-positive, human epidermal growth factor receptor 2–negative metastatic breast cancer (HR+ HER2− MBC), the mainstay treatment options include cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) and everolimus (EVE) in combination with endocrine treatment. This study aims to...

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Autores principales: Jeong, Hyehyun, Jeong, Jae Ho, Kim, Jeong Eun, Ahn, Jin-Hee, Jung, Kyung Hae, Kim, Sung-Bae
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Cancer Association 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9016296/
https://www.ncbi.nlm.nih.gov/pubmed/34176251
http://dx.doi.org/10.4143/crt.2021.205
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author Jeong, Hyehyun
Jeong, Jae Ho
Kim, Jeong Eun
Ahn, Jin-Hee
Jung, Kyung Hae
Kim, Sung-Bae
author_facet Jeong, Hyehyun
Jeong, Jae Ho
Kim, Jeong Eun
Ahn, Jin-Hee
Jung, Kyung Hae
Kim, Sung-Bae
author_sort Jeong, Hyehyun
collection PubMed
description PURPOSE: In hormone receptor-positive, human epidermal growth factor receptor 2–negative metastatic breast cancer (HR+ HER2− MBC), the mainstay treatment options include cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) and everolimus (EVE) in combination with endocrine treatment. This study aims to compare the outcomes of the following treatment sequences: CDK4/6i followed by EVE and EVE followed by CDK4/6i. MATERIALS AND METHODS: Data from HR+ HER2− MBC patients treated between January 2014 and November 2020 with both CDK4/6i and EVE were retrospectively analyzed. RESULTS: Among the 88 patients included in the study, 51 received CDK4/6i before EVE (C→E group), and 37 received EVE before CDK4/6i (E→C group) with endocrine treatment. More patients in the E→C group had endocrine resistance (13.7% vs. 40.5%), experienced palliative chemotherapy (7.8% vs. 40.5%), and were heavily treated (treated as ≥ 3rd line, 5.9% vs. 40.5%). Median overall survival was 46.8 months in the C→E group and 38.9 months in the E→C group (p=0.151). Median composite progression-free survival (PFS), defined as the time from the start of the preceding regimen to disease progression on the following regimen or death, was 24.8 months in the C→E group vs. 21.8 months in the E→C group (p=0.681). Median PFS2/PFS1 ratio did not differ significantly between groups (0.5 in the C→E group, 0.6 in the E→C group; p=0.775). Ten patients (11.4%) discontinued EVE, and two patients (2.3%) discontinued CDK4/6i during treatment. CONCLUSION: Although the CDK4/6i-based regimen should be considered as an earlier line of treatment, CDK4/6i- and EVE-based treatments can be valid options in circumstances where the other treatment had been already given.
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spelling pubmed-90162962022-04-27 Comparison of the Effectiveness and Clinical Outcome of Everolimus Followed by CDK4/6 Inhibitors with the Opposite Treatment Sequence in Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer Jeong, Hyehyun Jeong, Jae Ho Kim, Jeong Eun Ahn, Jin-Hee Jung, Kyung Hae Kim, Sung-Bae Cancer Res Treat Original Article PURPOSE: In hormone receptor-positive, human epidermal growth factor receptor 2–negative metastatic breast cancer (HR+ HER2− MBC), the mainstay treatment options include cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) and everolimus (EVE) in combination with endocrine treatment. This study aims to compare the outcomes of the following treatment sequences: CDK4/6i followed by EVE and EVE followed by CDK4/6i. MATERIALS AND METHODS: Data from HR+ HER2− MBC patients treated between January 2014 and November 2020 with both CDK4/6i and EVE were retrospectively analyzed. RESULTS: Among the 88 patients included in the study, 51 received CDK4/6i before EVE (C→E group), and 37 received EVE before CDK4/6i (E→C group) with endocrine treatment. More patients in the E→C group had endocrine resistance (13.7% vs. 40.5%), experienced palliative chemotherapy (7.8% vs. 40.5%), and were heavily treated (treated as ≥ 3rd line, 5.9% vs. 40.5%). Median overall survival was 46.8 months in the C→E group and 38.9 months in the E→C group (p=0.151). Median composite progression-free survival (PFS), defined as the time from the start of the preceding regimen to disease progression on the following regimen or death, was 24.8 months in the C→E group vs. 21.8 months in the E→C group (p=0.681). Median PFS2/PFS1 ratio did not differ significantly between groups (0.5 in the C→E group, 0.6 in the E→C group; p=0.775). Ten patients (11.4%) discontinued EVE, and two patients (2.3%) discontinued CDK4/6i during treatment. CONCLUSION: Although the CDK4/6i-based regimen should be considered as an earlier line of treatment, CDK4/6i- and EVE-based treatments can be valid options in circumstances where the other treatment had been already given. Korean Cancer Association 2022-04 2021-06-23 /pmc/articles/PMC9016296/ /pubmed/34176251 http://dx.doi.org/10.4143/crt.2021.205 Text en Copyright © 2022 by the Korean Cancer Association https://creativecommons.org/licenses/by-nc/4.0/This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Jeong, Hyehyun
Jeong, Jae Ho
Kim, Jeong Eun
Ahn, Jin-Hee
Jung, Kyung Hae
Kim, Sung-Bae
Comparison of the Effectiveness and Clinical Outcome of Everolimus Followed by CDK4/6 Inhibitors with the Opposite Treatment Sequence in Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer
title Comparison of the Effectiveness and Clinical Outcome of Everolimus Followed by CDK4/6 Inhibitors with the Opposite Treatment Sequence in Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer
title_full Comparison of the Effectiveness and Clinical Outcome of Everolimus Followed by CDK4/6 Inhibitors with the Opposite Treatment Sequence in Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer
title_fullStr Comparison of the Effectiveness and Clinical Outcome of Everolimus Followed by CDK4/6 Inhibitors with the Opposite Treatment Sequence in Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer
title_full_unstemmed Comparison of the Effectiveness and Clinical Outcome of Everolimus Followed by CDK4/6 Inhibitors with the Opposite Treatment Sequence in Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer
title_short Comparison of the Effectiveness and Clinical Outcome of Everolimus Followed by CDK4/6 Inhibitors with the Opposite Treatment Sequence in Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer
title_sort comparison of the effectiveness and clinical outcome of everolimus followed by cdk4/6 inhibitors with the opposite treatment sequence in hormone receptor–positive, her2-negative metastatic breast cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9016296/
https://www.ncbi.nlm.nih.gov/pubmed/34176251
http://dx.doi.org/10.4143/crt.2021.205
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