Real-world experience with CDK4-6 inhibition in the old and oldest old with a diagnosis of breast cancer

IF 3 3区医学 Q2 ONCOLOGY Seminars in oncology Pub Date : 2024-06-01 DOI:10.1053/j.seminoncol.2024.01.003

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Abstract

This study describes characteristics, toxicity and survival in old patients with HR+/HER2-breast cancer (BC) treated with CDK4/6 inhibitors. Retrospective observational study that included patients ≥ 75 years with HR+/HER2-BC treated with CDK4/6 inhibitors between 2017 and 2021. Patients’ general and cancer-related data were collected. Comprehensive Geriatric Assessment scales were gathered. Adverse events reported before each cycle were included. At the end of the follow-up period, mortality was retrospectively registered from medical records. All 19 patients (94.7% women, median age 77.9 ± 10.1) were at risk of frailty (G8 ≤ 14) and malnutrition (MNA-SF ≤ 11). Most were independent (52.7% Lawton ≥ 6), had no cognitive impairment (89.5%, MMSE ≥ 24), poor physical performance (70%, SPPB < 8; 62.5% TUG ≥ 12’’) and polypharmacy (72.2%). Almost half had stage IV disease (47.1%). Palbociclib+letrozole was the most frequently prescribed treatment (36.8%). All patients developed some toxicity (94.7% hematologic, 36.8% renal) but except one, grade ≤ 2. Over the 42-month follow-up period, 10 reported progression and 8 died. The median survival time was 19.9 ± 3.4 months. Five months after starting treatment, the probability of survival was 73%. At 30 months, 53% of patients survived. We found a high risk of frailty and drug toxicity in this small sample. Most patients presented hematologic toxicity but to a low degree. The probability of survival increases with treatment.

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在确诊患有乳腺癌的耄耋老人中使用 CDK4-6 抑制剂的实际经验

本研究描述了接受CDK4/6抑制剂治疗的HR+/HER2-乳腺癌（BC）老年患者的特征、毒性和生存情况。回顾性观察研究纳入了2017年至2021年间接受CDK4/6抑制剂治疗的≥75岁HR+/HER2-BC患者。收集了患者的一般和癌症相关数据。收集了老年综合评估量表。包括每个周期前报告的不良事件。在随访期结束时，根据医疗记录对死亡率进行了回顾性登记。所有 19 名患者（94.7% 为女性，中位年龄为 77.9±10.1 岁）都有虚弱（G8 ≤ 14）和营养不良（MNA-SF ≤ 11）的风险。大多数人都能独立生活（52.7% Lawton ≥ 6），没有认知障碍（89.5%，MMSE ≥ 24），体能较差（70%，SPPB < 8; 62.5% TUG ≥ 12''），并服用多种药物（72.2%）。近半数患者为 IV 期疾病（47.1%）。帕博西尼+来曲唑是最常用的处方治疗（36.8%）。所有患者都出现了一些毒性反应（94.7%为血液学反应，36.8%为肾脏反应），但有一名患者除外，毒性等级≤2。在 42 个月的随访期间，有 10 人报告病情恶化，8 人死亡。中位生存时间为（19.9 ± 3.4）个月。开始治疗 5 个月后，患者的生存概率为 73%。30个月后，53%的患者存活。我们发现，在这个小样本中，体弱和药物毒性的风险很高。大多数患者出现血液毒性，但程度较轻。随着治疗的进行，存活几率也会增加。

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来源期刊

Seminars in oncology 医学-肿瘤学

CiteScore

6.60

自引率

0.00%

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审稿时长

104 days

期刊介绍： Seminars in Oncology brings you current, authoritative, and practical reviews of developments in the etiology, diagnosis and management of cancer. Each issue examines topics of clinical importance, with an emphasis on providing both the basic knowledge needed to better understand a topic as well as evidence-based opinions from leaders in the field. Seminars in Oncology also seeks to be a venue for sharing a diversity of opinions including those that might be considered "outside the box". We welcome a healthy and respectful exchange of opinions and urge you to approach us with your insights as well as suggestions of topics that you deem worthy of coverage. By helping the reader understand the basic biology and the therapy of cancer as they learn the nuances from experts, all in a journal that encourages the exchange of ideas we aim to help move the treatment of cancer forward.

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Table of Contents Outside front cover Masthead Editorial Board Real-world experience with CDK4-6 inhibition in the old and oldest old with a diagnosis of breast cancer