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影响接受CDK 4/6抑制剂治疗的转移性乳腺癌患者生存的因素。

Factors Affecting the Survival of Metastatic Breast Cancer Patients Treated with CDK 4/6 Inhibitors.

作者信息

Sucuoğlu İşleyen Zehra, Muğlu Harun, Alaca Topçu Zeynep, Beşiroğlu Mehmet, Yasin Ayşe İrem, Topçu Atakan, Şimşek Melih, Şeker Mesut, Türk Hacı Mehmet

机构信息

Department of Medical Oncology, Bezmialem Vakif University Hospital, 34093 Istanbul, Turkey.

Department of Medical Oncology, Medipol University Hospital, 34214 Istanbul, Turkey.

出版信息

Medicina (Kaunas). 2025 Jul 16;61(7):1279. doi: 10.3390/medicina61071279.

Abstract

We aim to determine the efficacy and the factors associated with the effectiveness of first-line CDK4/6i (ribociclib or palbociclib) treatment in HR-positive, HER2-negative MBC patients. This is a retrospective, cross-sectional, and descriptive study. Ninety patients with metastatic breast cancer receiving CDK 4/6i treatment from three different oncology clinics were included in this study. Of the patients, 56 (62.2%) received ribociclib, and 34 (37.8%) were administered palbociclib. There was no significant difference between the groups regarding age, gender, comorbidities, ECOG performance status, or menopausal status ( > 0.05). The cut-off values for ER, PR, and Ki-67 levels were determined via ROC curve analysis. These values were found to be 80% for ER levels, 50% for PR levels, and 30% for Ki-67 levels. PFS was significantly longer for patients with ER levels greater than 80% and Ki-67 expression levels less than 30% according to multivariate analysis. Among the patients included in our study, the median PFS was 22.41 months for the patients with Ki-67 levels of 30% and above, while the median PFS was 17.24 months for the patients with ER levels of 80% and below. Among the patients with a combined ER of 80% or less and a Ki-67 of 30% or more, the median PFS was 12.42 months ( < 0.001). This study demonstrates that CDK4/6i therapies led to longer PFS among patients with ER levels greater than 80% and Ki-67 expression levels less than 30%. It is essential to determine which patient group benefits more from first-line CDK4/6is therapy.

摘要

我们旨在确定一线CDK4/6抑制剂(瑞博西尼或哌柏西利)治疗激素受体(HR)阳性、人表皮生长因子受体2(HER2)阴性转移性乳腺癌(MBC)患者的疗效及与疗效相关的因素。这是一项回顾性、横断面描述性研究。本研究纳入了来自三家不同肿瘤诊所接受CDK4/6抑制剂治疗的90例转移性乳腺癌患者。其中,56例(62.2%)接受瑞博西尼治疗,34例(37.8%)接受哌柏西利治疗。两组在年龄、性别、合并症、东部肿瘤协作组(ECOG)体能状态或绝经状态方面无显著差异(P>0.05)。通过受试者工作特征(ROC)曲线分析确定雌激素受体(ER)、孕激素受体(PR)和Ki-67水平的临界值。结果发现,ER水平的临界值为80%,PR水平为50%,Ki-67水平为30%。多因素分析显示,ER水平大于80%且Ki-67表达水平小于30%的患者无进展生存期(PFS)显著更长。在我们纳入研究的患者中,Ki-67水平在30%及以上的患者中位PFS为22.41个月,而ER水平在80%及以下的患者中位PFS为17.24个月。在ER合并水平为80%或更低且Ki-67为30%或更高的患者中,中位PFS为12.42个月(P<0.001)。本研究表明,CDK4/6抑制剂治疗使ER水平大于80%且Ki-67表达水平小于30%的患者PFS更长。确定哪类患者群体能从一线CDK4/6抑制剂治疗中获益更多至关重要。

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