Welcome to PracticeUpdate! We hope you are enjoying access to a selection of our top-read and most recent articles. Please register today for a free account and gain full access to all of our expert-selected content.
Already Have An Account? Log in Now
Overall Survival in Patients With HR+/HER2− Metastatic Breast Cancer Receiving CDK4/6 Inhibitors in Addition to Endocrine Therapy
TAKE-HOME MESSAGE
- In this SEER database study, the authors evaluated the survival outcomes of 630 women aged ≥65 years with de novo HR+/HER2− metastatic breast cancer treated with endocrine therapy (ET) with or without a CDK4/6 inhibitor. Patients who received a CKD4/6 inhibitor in addition to ET had superior survival outcomes. The time to treatment discontinuation and adherence were generally similar among patients who received palbociclib, ribociclib, and abemaciclib.
- The addition of a CDK4/6 inhibitor to ET improves overall survival in older women with HR+/HER2− metastatic breast cancer treated in a real‐world setting. Larger studies are needed to compare the real-world outcomes of women treated with the individual CDK4/6 inhibitors.
- Written by
-
Lillie D. Shockney RN, BS, MAS, HON-ONN-CG
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
Evidence on overall survival (OS) with cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors is generally limited to data from clinical trials or a few observational studies with limited generalizability to Medicare population. The aim of this study was to determine OS benefits associated with CDK4/6 inhibitors in older Medicare patients with hormone receptor (HR)-positive and human epidermal growth factor receptor-2 overexpressing (HER2-) metastatic breast cancer (MBC).
METHODS
In a retrospective cohort design, female patients aged ≥65 years with diagnosis of HR+/HER2- MBC from 2015 to 2017 who initiated first-line systemic therapy within 12 months of MBC diagnosis were selected from the Survey Epidemiology and End Results-Medicare database. The effect of treatment type (endocrine therapy [ET]+CDK4/6 inhibitor vs. ET alone) on OS was analyzed using Kaplan-Meier methods and multivariable Cox regression models. Adjusted hazard ratio (aHR) and 95% CIs were estimated.
RESULTS
A total of 630 eligible patients were identified (169 patients treated with ET+CDK4/6 inhibitor and 461 patients treated with ET alone). In the Kaplan-Meier analysis, OS rate at 3 years after first-line treatment initiation was 73.0% for ET+CDK4/6 inhibitor versus 49.1% for ET alone (log-rank p < .0001). In Cox regression analysis, first-line ET+CDK4/6 inhibitor therapy was associated with 41% lower rate of mortality versus ET alone (aHR, 0.590; 95% CI, 0.423-0.823).
CONCLUSIONS
The findings of this real-world study demonstrate significant OS benefit associated with ET+CDK4/6 inhibitor therapy over ET alone in an older Medicare population of patients with HR+/HER2- MBC, largely consistent with the evidence from clinical trials.
Additional Info
Disclosure statements are available on the authors' profiles:
Overall survival associated with CDK4/6 inhibitors in patients with HR+/HER2- metastatic breast cancer in the United States: A SEER-Medicare population-based study
Cancer 2023 Feb 09;[EPub Ahead of Print], RK Goyal, H Chen, SM Abughosh, HM Holmes, SD Candrilli, ML JohnsonFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.