Oncology Department, Institut de Cancérologie Strasbourg-Europe, 17 avenue Albert Calmette 672000 Strasbourg, France.
Oncology Department, Institut de Cancérologie Strasbourg-Europe, 17 avenue Albert Calmette 672000 Strasbourg, France.
Cancer Treat Res Commun. 2023;36:100738. doi: 10.1016/j.ctarc.2023.100738. Epub 2023 Jun 25.
The combination of endocrine treatment with cycline-dependent-kinase 4/6 inhibitor is the new standard of treatment in hormone receptor-positive HER2 negative metastatic breast cancer. The optimal subsequent treatment after CDK4/6 inhibitor remain unclear. As recommended by standard guidelines, capecitabine, an oral chemotherapy is a therapeutic option in endocrine resistant metastatic breast cancer. The objective of this study was to evaluate capecitabine efficacy after disease progression under combination of ET and CDK4/6 inhibitor in a hormone receptor positive metastatic breast cancer population.
Patients progressing under CDK 4/6 inhibitor plus ET and treated with capecitabine, between January 2016 and December 2020, were retrospectively included. Primary endpoint was time to treatment failure (TTF) on capecitabine. Logistic regression were used to identify predictive factors: exclusive bone versus visceral metastases, first-line versus ≥ 2 lines of combination therapy, aromatase inhibitor (AI) versus fulvestrant.
Fifty-six patients with a 62-year median age (IC95% 42-81) were analyzed. The CDK 4/6 inhibitor and ET combination was prescribed in first-line setting in 26 patients (46%). Twenty-five patients (44%) had exclusive bone metastasis. Median TTF was 6.1 months. Six patients discontinued capecitabine due to toxicity. Outcomes were not significantly different regardless of metastases localization, ET, and treatment line of the combination of CDK 4/6 inhibitor and ET. Median PFS was 7.1 months. Median OS was 41.3 months.
Compared to other data of capecitabine prescribed in patients with hormonal resistant MBC, this retrospective study suggests that capecitabine remains effective after CDK 4/6 inhibitor plus ET progression, regardless of therapeutic-line setting and metastases localization.
Cycline dependant kinase 4/6 inhibitor plus endocrine therapy have become the standard of care in metastatic hormone receptor positive (HR+) breast cancer (BC). Few data reported the optimal subsequent therapy after progression under the combination. Capecitabine is a therapeutic option in endocrine resistant HR+/HER2- metastatic breast cancer. Data evaluating efficacy of capecitabine after disease progression on endocrine therapy plus cycline-dependant kinase 4/6 inhibitor are poor. This study showed a 6.1-month median time to treatment failure on capecitabine. Capecitabine remained effective regardless of therapeutic-line setting and metastases localization.
内分泌治疗联合细胞周期蛋白依赖性激酶 4/6 抑制剂（CDK4/6i）是激素受体阳性（HR+）HER2 阴性转移性乳腺癌的新标准治疗方法。CDK4/6i 治疗后最佳的后续治疗方案仍不清楚。根据标准指南建议，卡培他滨作为一种口服化疗药物，是内分泌耐药转移性乳腺癌的一种治疗选择。本研究的目的是评估在 HR+转移性乳腺癌人群中，CDK4/6i 联合内分泌治疗进展后使用卡培他滨的疗效。
回顾性纳入 2016 年 1 月至 2020 年 12 月期间，在 CDK4/6i 联合内分泌治疗进展后接受卡培他滨治疗的患者。主要终点是卡培他滨治疗失败时间（TTF）。采用逻辑回归分析来识别预测因素：单纯骨转移与内脏转移、一线治疗与≥2 线联合治疗、芳香化酶抑制剂（AI）与氟维司群。
共分析了 56 例中位年龄为 62 岁（IC95%：42-81）的患者。在 26 例（46%）患者中，CDK4/6i 联合内分泌治疗被用于一线治疗。25 例（44%）患者仅有骨转移。中位 TTF 为 6.1 个月。有 6 例患者因毒性而停止使用卡培他滨。无论转移部位、内分泌治疗和 CDK4/6i 联合治疗的治疗线数如何，结果均无显著差异。中位无进展生存期（PFS）为 7.1 个月。中位总生存期（OS）为 41.3 个月。
与其他关于卡培他滨用于激素耐药性 MBC 的数据相比，本回顾性研究表明，在 CDK4/6i 联合内分泌治疗进展后，无论治疗线设置和转移部位如何，卡培他滨仍然有效。
