"Sandro Pitigliani" Translational Research Unit, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy.
"Sandro Pitigliani" Translational Research Unit, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy.
Cancer Treat Rev. 2021 Feb;93:102136. doi: 10.1016/j.ctrv.2020.102136. Epub 2020 Dec 7.
CDK4/6 inhibitors (CDK4/6i) in combination with endocrine therapy are the mainstay of treatment for patients with hormone receptor-positive, HER2 negative (HR+/HER2neg) metastatic breast cancer. However, resistance - either de novo or acquired - invariably occurs, leading to treatment failure and cancer progression. Genomic alterations, gene expression data and circulating biomarkers have been correlated to response to treatment, but to date no biomarker has been approved to stratify patients. Treatment strategies after progression on CDK4/6i are yet to be standardized. Current approaches include endocrine therapy alone or in combination with target therapy, or chemotherapy. New agents are in clinical development based on potential mechanisms of acquired resistance. Here we will review recent advancements in biomarkers of response to CDK4/6i, and in post- treatment therapeutic strategies.
CDK4/6 抑制剂（CDK4/6i）联合内分泌治疗是激素受体阳性、HER2 阴性（HR+/HER2neg）转移性乳腺癌患者的主要治疗方法。然而，不可避免地会出现耐药性——无论是原发性耐药还是获得性耐药，从而导致治疗失败和癌症进展。基因组改变、基因表达数据和循环生物标志物与治疗反应相关，但迄今为止，没有生物标志物被批准用于患者分层。在 CDK4/6i 治疗进展后的治疗策略尚未标准化。目前的方法包括内分泌治疗单独或联合靶向治疗，或化疗。基于获得性耐药的潜在机制，新的药物正在临床开发中。在这里，我们将回顾 CDK4/6i 反应的生物标志物和治疗后治疗策略的最新进展。
