Walbaum Benjamín, Reyes José Miguel, Rodriguez Pablo, Muñiz Sabrina, Medina Lidia, Ibañez Carolina, Merino Tomas, Pinto Mauricio P, Bravo Maria Loreto, Acevedo Francisco, Bennett José, Sanchez Cesar
Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile.
Dr. Sótero del Río Hospital and Healthcare Complex, Santiago 8207257, Chile.
Ecancermedicalscience. 2023 Nov 21;17:1636. doi: 10.3332/ecancer.2023.1636. eCollection 2023.
The addition of cyclin-dependent kinases inhibitors (CDKi) to endocrine therapy (ET) as the first- or second line treatment improves progression-free and overall survival (OS) in hormone receptor-positive, HER2 negative (HR+/HER2-) advanced stage breast cancer (ABC). Our study compared survival rates and prognostic factors in Chilean patients that used palbociclib as first or subsequent (≥second) lines of treatment in a real-world setting.
Our retrospective population-cohort study included HR+/HER2- ABC patients. We calculated 5-year OS and performed a multivariate analysis to determine prognostic factors.
A total of 106 patients were included. Median age was 49 years (19-86), 28.3% (30) had de novo stage IV disease; 63% received palbociclib with ET as first line, 54% of them with aromatase inhibitor over fulvestrant. Median OS for the entire cohort was 99 months and 5-year OS was 69%. Patients that received first line palbociclib had a 5-year OS of 89% versus 43% for ET monotherapy or ≥second line palbociclib ( = 0.0062). Multivariate analysis showed that the year at diagnosis and CDKi timing (first line versus ≥second line) were significantly associated with OS.
Our real-world data show that first-line CDKi + ET provides a statistically significant benefit in OS versus ≥second line in HR+/HER2- ABC patients.
在内分泌治疗（ET）基础上加用细胞周期蛋白依赖性激酶抑制剂（CDKi）作为一线或二线治疗，可改善激素受体阳性、人表皮生长因子受体2阴性（HR+/HER2-）晚期乳腺癌（ABC）患者的无进展生存期和总生存期（OS）。我们的研究比较了在真实世界中使用哌柏西利作为一线或后续（≥二线）治疗的智利患者的生存率和预后因素。
我们的回顾性人群队列研究纳入了HR+/HER2- ABC患者。我们计算了5年总生存期，并进行多变量分析以确定预后因素。
共纳入106例患者。中位年龄为49岁（19 - 86岁），28.3%（30例）为初发IV期疾病；63%的患者接受哌柏西利联合ET作为一线治疗，其中54%使用芳香化酶抑制剂而非氟维司群。整个队列的中位总生存期为99个月，5年总生存率为69%。接受一线哌柏西利治疗的患者5年总生存率为89%，而ET单药治疗或≥二线哌柏西利治疗的患者为43%（P = 0.0062）。多变量分析显示，诊断年份和CDKi使用时机（一线治疗与≥二线治疗）与总生存期显著相关。
我们的真实世界数据表明，在HR+/HER2- ABC患者中，一线CDKi + ET与≥二线治疗相比，在总生存期方面具有统计学上的显著优势。
