The effect of dose reduction of CDK4/6 inhibitors on survival in postmenopausal HR+ HER2-negative metastatic breast cancer.

IF 2.8 3区医学 Q2 ONCOLOGY Expert Review of Anticancer Therapy Pub Date : 2025-05-01 Epub Date: 2025-04-10 DOI:10.1080/14737140.2025.2490289

Furkan Ceylan, Safa Can Efil, Didem Şener Dede, Ates Kutay Tenekeci, Burak Bilgin, Şebnem Yücel, Eren Göktuğ Ceylan, Mutlu Hızal, Mehmet Ali Nahit Şendur, Muhammed Bülent Akıncı, Öznur Bal, Bülent Yalçın

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Abstract

Background: This study aimed to evaluate the effect of dose reduction of CDK4/6 inhibitors on survival outcomes in postmenopausal patients with HR+HER2-negative metastatic breast cancer (mBC).

Methods: A retrospective cohort study was conducted involving 164 postmenopausal patients with HR+ HER2-negative mBC who received CDK4/6 inhibitors between 2021 and 2024. Clinical parameters were systematically analyzed. Progression-free survival (PFS) and overall survival (OS) were evaluated based on dose reduction status. Survival outcomes were estimated using the Kaplan-Meier method, and independent prognostic factors were identified through multivariate Cox regression analysis.

Results: The median age was 61 years, with a median follow-up of 23.5 months. The median PFS was 23.3 months, while median OS was not reached. Dose reduction occurred in 45 patients (27%), who exhibited significantly worse survival (PFS HR: 1.67, 95% CI: 1.02-2.72, p = 0.042; OS HR: 2.54, 95% CI:1.34-4.83, p = 0.004). Dose reduction and liver metastases were independent risk factors for shorter PFS and OS, while treatment in later lines was associated with shorter PFS.

Conclusion: Dose reductions in CDK4/6 inhibitors were associated with worse survival outcomes in postmenopausal HR+ HER2- mBC patients. Future biomarker-driven studies are needed to guide personalized dose adjustments and optimize treatment efficacy.

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CDK4/6抑制剂剂量减少对绝经后HR+ her2阴性转移性乳腺癌患者生存的影响

背景：本研究旨在评估CDK4/6抑制剂减少剂量对绝经后HR+ her2阴性转移性乳腺癌（mBC）患者生存结局的影响。方法：对164例绝经后HR+ her2阴性mBC患者进行回顾性队列研究，这些患者在2021年至2024年间接受了CDK4/6抑制剂治疗。系统分析临床参数。基于剂量减少状态评估无进展生存期（PFS）和总生存期（OS）。使用Kaplan-Meier法估计生存结果，并通过多变量Cox回归分析确定独立预后因素。结果：中位年龄61岁，中位随访23.5个月。中位PFS为23.3个月，而中位OS未达到。45例（27%）患者出现剂量减少，生存率明显降低(PFS HR: 1.67, 95% CI: 1.02-2.72, p = 0.042；OS HR: 2.54, 95% CI: 1.34-4.83, p = 0.004)。剂量减少和肝转移是缩短PFS和OS的独立危险因素，而在较晚的系列中治疗与缩短PFS相关。结论：CDK4/6抑制剂的剂量减少与绝经后HR+ HER2- mBC患者的生存结果较差相关。未来需要生物标志物驱动的研究来指导个性化剂量调整和优化治疗效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Anticancer Therapy 医学-肿瘤学

CiteScore

5.10

自引率

3.00%

发文量

100

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anticancer Therapy (ISSN 1473-7140) provides expert appraisal and commentary on the major trends in cancer care and highlights the performance of new therapeutic and diagnostic approaches. Coverage includes tumor management, novel medicines, anticancer agents and chemotherapy, biological therapy, cancer vaccines, therapeutic indications, biomarkers and diagnostics, and treatment guidelines. All articles are subject to rigorous peer-review, and the journal makes an essential contribution to decision-making in cancer care. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.