Brufsky Adam, Liu Xianchen, Li Benjamin, McRoy Lynn, Chen Connie, Layman Rachel M, Rugo Hope S
UPMC Hillman Cancer Center, Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Pfizer Inc., New York, NY 10001, USA.
Cancers (Basel). 2023 Nov 2;15(21):5268. doi: 10.3390/cancers15215268.
A cyclin-dependent kinase 4/6 inhibitor combined with endocrine therapy is the standard of care for patients with hormone receptor-positive/human epidermal growth factor 2-negative (HR+/HER2-) metastatic breast cancer (mBC), but real-world effectiveness data for patients with lung or liver metastases are limited. This retrospective study included data from the US Flatiron Health database of patients with HR+/HER2- mBC and lung or liver metastases treated with first-line palbociclib (PAL) plus an aromatase inhibitor (AI) or an AI alone in routine clinical practice. Overall survival (OS) and real-world progression-free survival (rwPFS) were assessed. A total of 891 patients were included (622 with lung metastasis, 376 with liver metastasis, and 107 with both lung and liver metastasis). After stabilized inverse probability of treatment weighting to balance patient characteristics, PAL + AI versus AI alone was associated with significantly prolonged OS (HR = 0.62; < 0.001) and rwPFS (HR = 0.55; < 0.001) in patients with lung metastases and numerically longer OS (HR = 0.73; = 0.056) and significantly longer rwPFS (HR = 0.57, < 0.001) for those with liver metastases. Overall, PAL + AI versus AI alone was associated with prolonged OS and rwPFS in routine clinical practice, supporting the use of first-line PAL + AI for patients with HR+/HER2- mBC with lung and/or liver metastases.
细胞周期蛋白依赖性激酶4/6抑制剂联合内分泌治疗是激素受体阳性/人表皮生长因子2阴性(HR+/HER2-)转移性乳腺癌(mBC)患者的标准治疗方案,但针对有肺或肝转移患者的真实世界有效性数据有限。这项回顾性研究纳入了美国Flatiron Health数据库中HR+/HER2- mBC且有肺或肝转移的患者数据,这些患者在常规临床实践中接受一线哌柏西利(PAL)加芳香化酶抑制剂(AI)或仅接受AI治疗。评估了总生存期(OS)和真实世界无进展生存期(rwPFS)。共纳入891例患者(622例有肺转移,376例有肝转移,107例同时有肺和肝转移)。在进行稳定的逆概率治疗加权以平衡患者特征后,对于有肺转移的患者,PAL + AI对比单独使用AI与显著延长的OS(HR = 0.62;<0.001)和rwPFS(HR = 0.55;<0.001)相关,对于有肝转移的患者,PAL + AI对比单独使用AI在数值上有更长的OS(HR = 0.73;= 0.056)和显著更长的rwPFS(HR = 0.57,<0.001)。总体而言,在常规临床实践中,PAL + AI对比单独使用AI与延长的OS和rwPFS相关,支持对有肺和/或肝转移的HR+/HER2- mBC患者使用一线PAL + AI治疗。