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安达卢西亚地区局部晚期/转移性 HR/HER2 乳腺癌患者的临床实践回顾性登记研究。

Retrospective registry of patients with locally advanced/metastatic HR/HER2 breast cancer treated in clinical practice in Andalusia.

机构信息

Medical Oncology Service, Instituto de Investigación E Innovación Biomédica de Cádiz (INIBiCA), Institute for Biomedica Research and Innovation, Hospital Universitario de Jerez de La Frontera, Jerez, Cadiz, Spain.

Medical Oncology Service, Instituto de Investigación Biosanitaria de Granada (Ibs.Granada) and Medicine Department, Hospital Universitario San Cecilio, Granada University, Granada, Spain.

出版信息

Clin Transl Oncol. 2024 Dec;26(12):3131-3141. doi: 10.1007/s12094-024-03510-8. Epub 2024 Jun 3.

Abstract

BACKGROUND

Limited data are available regarding the real-world effectiveness and safety of Cyclin Dependent Kinase 4/6 inhibitor (CDK4/6i) (palbociclib/ribociclib) just as a first-line treatment for patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR + /HER2‒) metastatic breast cancer (MBC).

OBJECTIVE

To assess whether clinical or demographic characteristics limit access to first-line CDK4/6i treatment in clinical practice in the Autonomous Community of Andalusia (Spain) between November 2017 and April 2020. In addition, effectiveness will be described in an exploratory analysis.

METHODS

Physicians from 12 centers participated in selecting demographic and clinical characteristics, treatment, and outcome data from women with HR + /HER2- MBC treated with or without CDK4/6i in addition to hormonal in the first-line setting, in a 3:1 proportion. Kaplan-Meier analysis estimated progression-free rates (PFRs) and survival rates (SRs).

RESULTS

A total of 212 patients were included, of whom 175 (82.5%) were in the CDK4/6i treatment group and 37 (17.5%) were in the non-CDK4/6i treatment group (control group). Patients in the CDK 4/6i treatment group were younger (p = 0.0011), the biopsies of the metastatic site at the moment of the relapse were most commonly performed (p = 0.0454), and had multiple metastatic sites (p = 0.0025). The clinical benefit rate (CBR) was 82.3% in the CDK4/6i group and 67.8% in the control group. Median time to a progression event or death (PFS) was 20.4 months (95%CI 15.6-28) in the CDK4/6i group and 12.1 months (95%CI 7.9-not reached) in the control group.

CONCLUSIONS

Younger patients, biopsies of metastatic disease and with multiple metastatic sites were more frequently treated with CDK4/6i in our daily clinical practice.

摘要

背景

关于细胞周期蛋白依赖性激酶 4/6 抑制剂(CDK4/6i)(帕博西尼/瑞博西尼)作为激素受体阳性/人表皮生长因子受体 2 阴性(HR+/HER2-)转移性乳腺癌(MBC)患者一线治疗的真实世界疗效和安全性,数据有限。

目的

评估 2017 年 11 月至 2020 年 4 月期间,在西班牙安达卢西亚自治区(Andalusia)的临床实践中,是否存在临床或人口统计学特征限制了一线 CDK4/6i 治疗的应用。此外,还将进行探索性分析以描述疗效。

方法

来自 12 个中心的医生参与了选择除激素治疗外,在一线治疗中接受或未接受 CDK4/6i 联合激素治疗的 HR+/HER2-MBC 女性患者的人口统计学和临床特征、治疗和结局数据,比例为 3:1。Kaplan-Meier 分析估计无进展率(PFR)和生存率(SR)。

结果

共纳入 212 例患者,其中 175 例(82.5%)接受 CDK4/6i 治疗,37 例(17.5%)接受非 CDK4/6i 治疗(对照组)。CDK4/6i 治疗组患者更年轻(p=0.0011),复发时转移部位活检最常见(p=0.0454),且转移部位更多(p=0.0025)。CDK4/6i 组的临床获益率(CBR)为 82.3%,对照组为 67.8%。CDK4/6i 组中位至进展或死亡时间(PFS)为 20.4 个月(95%CI 15.6-28),对照组为 12.1 个月(95%CI 7.9-未达到)。

结论

在我们的日常临床实践中,年轻患者、转移疾病的活检和更多的转移部位更常接受 CDK4/6i 治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1e0/11564311/42efffb4fd13/12094_2024_3510_Fig1_HTML.jpg

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