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. 2020 Jul 23:14:1178223420944864.
doi: 10.1177/1178223420944864. eCollection 2020.

Outcome of Everolimus-Based Therapy in Hormone-Receptor-Positive Metastatic Breast Cancer Patients After Progression on Palbociclib

Ajay Dhakal  1 , Roby Antony Thomas  2 , Ellis G Levine  3 , Adam Brufsky  2 , Kazuaki Takabe  3 , Matthew G Hanna  4 , Kristopher Attwood  3 , Austin Miller  3 , Thaer Khoury  3 , Amy P Early  3 , Saif Soniwala  3 , Tracy O'Connor  3 , Mateusz Opyrchal  5
Affiliations

Outcome of Everolimus-Based Therapy in Hormone-Receptor-Positive Metastatic Breast Cancer Patients After Progression on Palbociclib

Ajay Dhakal et al. Breast Cancer (Auckl). .

Abstract

Background: Despite the approval of mTOR inhibitor everolimus and CDK4/6 inhibitors in the management of hormone-receptor-positive HER2 non-amplified metastatic breast cancer (HR+ HER2-MBC), the optimal sequence of therapy is unclear. There are no clinical data on efficacy of everolimus in HR+ HER2-MBC after cancer progresses on CDK4/6 inhibitors.

Objective: The objective of this study is to find the efficacy of everolimus in HR+ HER2-MBC after they progress on a CDK4/6 inhibitor palbociclib.

Methods: This is a retrospective, 2-institute review of HR+ HER2-MBC from Jan 2015 to March 2018 treated with everolimus after progression on palbociclib. Primary end point was median progression-free survival (PFS), secondary end points objective response rate (ORR), clinical benefit ratio (CBR), and overall survival (OS).

Results: Out of 41 women with median age 61 years (33, 87) enrolled, 66% had received adjuvant systemic therapy, 61% had visceral disease, and 95% had prior nonsteroidal aromatase inhibitors. About 83% women had 3 or more chemotherapy or hormonal therapies prior to everolimus. Kaplan-Meier estimates showed a median PFS of 4.2 months (95% confidence interval [CI]: 3.2-6.2). The median OS was 18.7 months (95% CI 9.5 to not reached). Objective response rate and CBR were both 17.1%.

Conclusion: Everolimus was associated with modest PFS and ORR in HR+ HER2-MBCs postprogression on palbociclib.

Keywords: Metastatic breast cancer; estrogen receptor-positive breast cancer; everolimus; palbociclib.

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Conflict of interest statement

Declaration of conflicting interests:The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: E.G.L. has received royalty from UpToDate. A.B. has/had consulting or advisory role for Agendia, Bayer, bioTheranostics, Celgene, Genentech/Roche, Genomic Health, Lilly, NanoString Technologies, Novartis, Pfizer, and Puma Biotechnology. A.P.E. has received honorarium from Pfizer. M.O. has received research fund from Pfizer/NCCN and has/had consulting or advisory role for Novartis and AstraZeneca. A.D. has received honorarium from Daiichi Sankyo. All other authors declare that they have no conflict of interest.

Figures

Figure 1.
Figure 1.
Kaplan-Meier estimates show a median progression-free survival of 4.2 months (95% CI: 3.2-6.2). CI indicates confidence interval.
Figure 2.
Figure 2.
Kaplan-Meier estimates show a median overall survival of 18.7 months (95% CI: 9.5 to not reached). CI indicates confidence interval.
See this image and copyright information in PMC

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