HR+/HER2-晚期乳腺癌中CDK4/6抑制剂与mTOR抑制剂的不同给药顺序：一项多中心真实世界研究。
The different sequences of CDK4/6 inhibitor and mTOR inhibitor in HR+/HER2-advanced breast cancer: A multicenter real-world study.
作者信息
Liao Yuqian, Tan Yujing, Li Yipeng, Ma Fei, Wang Jiayu, Zhang Pin, Li Qing, Li Qiao, Luo Yang, Lan Bo, Chen Shanshan, Xu Binghe, Jiang Hanfang, Zhao Weihong, Fan Ying
机构信息
Department of Oncology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, 330006, China.
Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
出版信息
Heliyon. 2024 Sep 19;10(19):e38147. doi: 10.1016/j.heliyon.2024.e38147. eCollection 2024 Oct 15.
BACKGROUND
Cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) and everolimus (EVE) are effective for patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (MBC). However, the efficacy of different sequences of CDK4/6i and EVE are largely unknown. The study aimed to explore the efficacy of different sequences in China.
METHODS
146 patients with HR+/HER2- MBC who received both CDK4/6i and EVE in salvage setting were collected. Objective response rate (ORR), clinical benefit rate (CBR), progression-free survival (PFS), and overall survival (OS) were investigated.
RESULTS
56 patients received CDK4/6i prior to EVE (Group A), 90 patients received CDK4/6i subsequent to EVE (Group B). The median PFS of CDK4/6i and EVE in Group A vs Group B were 8.4m and 2.5m vs 4.6m and 6.1m respectively. The total PFS of first-line and second-line endocrine therapy were not different between Group A and Group B [13.1m vs 17.7m ( = 0.330, HR = 0.738, 95%CI: 0.399-1.365)]. The 5y OS of patients in Group A or Group B were 62.0 % vs 57.4 %, = 0.569.
CONCLUSIONS
We found that no matter CDK4/6i or EVE was used first, the survival were not significantly different between Group A and Group B. Both can be clinical options.
背景
细胞周期蛋白依赖性激酶4/6抑制剂（CDK4/6i）和依维莫司（EVE）对激素受体阳性（HR+）、人表皮生长因子受体2阴性（HER2-）转移性乳腺癌（MBC）患者有效。然而，CDK4/6i和EVE不同给药顺序的疗效在很大程度上尚不清楚。本研究旨在探索在中国不同给药顺序的疗效。
方法
收集146例在挽救治疗中同时接受CDK4/6i和EVE的HR+/HER2-MBC患者。研究客观缓解率（ORR）、临床获益率（CBR）、无进展生存期（PFS）和总生存期（OS）。
结果
56例患者先接受CDK4/6i后接受EVE（A组），90例患者先接受EVE后接受CDK4/6i（B组）。A组与B组中CDK4/6i和EVE的中位PFS分别为8.4个月和2.5个月对比4.6个月和6.1个月。A组和B组一线和二线内分泌治疗的总PFS无差异[13.1个月对比17.7个月（P=0.330，HR=0.738，95%CI：0.399-1.365）]。A组或B组患者的5年OS分别为62.0%对比57.4%，P=0.569。
结论
我们发现，无论先使用CDK4/6i还是EVE，A组和B组之间生存率无显著差异。两者均可作为临床选择。
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