Department of Pharmacy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
Division of General Surgery, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City, Taiwan.
Thorac Cancer. 2023 Oct;14(30):3012-3019. doi: 10.1111/1759-7714.15090. Epub 2023 Sep 4.
Cyclin-dependent kinases 4 and 6 inhibitors (CDK4/6i) have been shown to improve progression-free survival (PFS) in patients with metastatic breast cancer (MBC) in randomized control trials. This study aimed to evaluate the efficacy and safety of CDK4/6i in patients with advanced breast cancer (ABC) in a clinical setting.
Consecutive patients with ABC were treated between October 2019 and March 2023 at Taipei Tzu Chi Hospital, Taiwan. Patients who had received at least one dose of CDK4/6i were included in this retrospective study. The main outcome of this study was efficacy based on the treating physicians' assessments in terms of PFS, and overall survival (OS), as well as the factors associated with patient outcome. The secondary outcome was safety.
A total of 85 patients were included in the analysis, with a mean age of 66.8 years. After a median follow-up of 16.1 months, the median PFS was 28.4 months (95% CI: 22.5-33.6) and the median OS could not yet be estimated. The most common adverse events (AE) were fatigue (50.8%), anorexia (45.9%), and leukopenia (44.7%). In multivariable analysis, treatment with CDK4/6i with any grade AE or response to treatment effect (CR/PR) was an independent predictor for longer PFS (hazard ratio [HR] = 0.27, 95% CI: 0.11-0.68; HR = 0.21, 95% CI: 0.06-0.67; p < 0.05).
CDK4/6i administered in a real-world setting exhibits a similar survival benefit with the clinical trials.
在随机对照试验中,细胞周期蛋白依赖性激酶 4 和 6 抑制剂(CDK4/6i)已被证明可改善转移性乳腺癌(MBC)患者的无进展生存期(PFS)。本研究旨在评估 CDK4/6i 在临床环境中治疗晚期乳腺癌(ABC)患者的疗效和安全性。
2019 年 10 月至 2023 年 3 月,台湾台北慈济医院连续收治 ABC 患者。本回顾性研究纳入至少接受过一次 CDK4/6i 治疗的患者。本研究的主要结局是根据治疗医生对 PFS 和总生存期(OS)的评估评估疗效,以及与患者结局相关的因素。次要结局是安全性。
共 85 例患者纳入分析,平均年龄为 66.8 岁。中位随访 16.1 个月后,中位 PFS 为 28.4 个月(95%CI:22.5-33.6),中位 OS 尚未可评估。最常见的不良反应(AE)为乏力(50.8%)、厌食(45.9%)和白细胞减少(44.7%)。多变量分析显示,任何等级 AE 或治疗效果反应(CR/PR)的 CDK4/6i 治疗与更长的 PFS 相关(风险比 [HR] = 0.27,95%CI:0.11-0.68;HR = 0.21,95%CI:0.06-0.67;p < 0.05)。
在真实环境中使用 CDK4/6i 治疗与临床试验具有相似的生存获益。