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. 2023 Feb 10;23(1):136.
doi: 10.1186/s12885-023-10609-8.

Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy

Cengiz Karacin  1 , Berna Oksuzoglu  2 , Ayşe Demirci  3 , Merve Keskinkılıç  4 , Naziyet Köse Baytemür  5 , Funda Yılmaz  2 , Oğuzhan Selvi  6 , Dilek Erdem  7 , Esin Avşar  8 , Nail Paksoy  9 , Necla Demir  10 , Sema Sezgin Göksu  11 , Sema Türker  12 , Ertuğrul Bayram  13 , Abdüssamet Çelebi  14 , Hatice Yılmaz  15 , Ömer Faruk Kuzu  16 , Seda Kahraman  16 , İvo Gökmen  17 , Abdullah Sakin  18 , Ali Alkan  19 , Erdinç Nayır  20 , Muzaffer Uğraklı  21 , Ömer Acar  22 , İsmail Ertürk  23 , Hacer Demir  24 , Ferit Aslan  25 , Özlem Sönmez  26 , Taner Korkmaz  26 , Özde Melisa Celayir  26 , İbrahim Karadağ  27 , Erkan Kayıkçıoğlu  28 , Teoman Şakalar  29 , İlker Nihat Öktem  30 , Tülay Eren  31 , Enes Erul  32 , Eda Eylemer Mocan  33 , Ziya Kalkan  34 , Nilgün Yıldırım  35 , Yakup Ergün  36 , Baran Akagündüz  37 , Serdar Karakaya  38 , Engin Kut  39 , Fatih Teker  40 , Burçin Çakan Demirel  41 , Kubilay Karaboyun  42 , Elvina Almuradova  43 , Olçun Ümit Ünal  44 , Abdilkerim Oyman  45 , Deniz Işık  46 , Kerem Okutur  47 , Buğra Öztosun  48 , Burcu Belen Gülbağcı  3 , Mehmet Emin Kalender  49 , Elif Şahin  50 , Mustafa Seyyar  50 , Özlem Özdemir  51 , Fatih Selçukbiricik  52 , Metin Kanıtez  53 , İsa Dede  54 , Mahmut Gümüş  48 , Erhan Gökmen  43 , Arzu Yaren  41 , Serkan Menekşe  39 , Senar Ebinç  34 , Sercan Aksoy  32 , Gökşen İnanç İmamoğlu  31 , Mustafa Altınbaş  31 , Bülent Çetin  28 , Başak Oyan Uluç  26 , Özlem Er  26 , Nuri Karadurmuş  23 , Atike Pınar Erdoğan  22 , Mehmet Artaç  21 , Özgür Tanrıverdi  19 , İrfan Çiçin  17 , Mehmet Ali Nahit Şendur  16 , Esin Oktay  15 , İbrahim Vedat Bayoğlu  14 , Semra Paydaş  13 , Adnan Aydıner  9 , Derya Kıvrak Salim  8 , Çağlayan Geredeli  6 , Tuğba Yavuzşen  4 , Mutlu Doğan  2 , İlhan Hacıbekiroğlu  3
Affiliations

Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy

Cengiz Karacin et al. BMC Cancer. .

Erratum in

  • Correction: Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy.
    Karacin C, Oksuzoglu B, Demirci A, Keskinkılıç M, Baytemür NK, Yılmaz F, Selvi O, Erdem D, Avşar E, Paksoy N, Demir N, Göksu SS, Türker S, Bayram E, Çelebi A, Yılmaz H, Kuzu ÖF, Kahraman S, Gökmen İ, Sakin A, Alkan A, Nayır E, Uğraklı M, Acar Ö, Ertürk İ, Demir H, Aslan F, Sönmez Ö, Korkmaz T, Celayir ÖM, Karadağ İ, Kayıkçıoğlu E, Şakalar T, Öktem İN, Eren T, Erul E, Mocan EE, Kalkan Z, Yıldırım N, Ergün Y, Akagündüz B, Karakaya S, Kut E, Teker F, Demirel BÇ, Karaboyun K, Almuradova E, Ünal OÜ, Oyman A, Işık D, Okutur K, Öztosun B, Gülbağcı BB, Kalender ME, Şahin E, Seyyar M, Özdemir Ö, Selçukbiricik F, Kanıtez M, Dede İ, Gümüş M, Gökmen E, Yaren A, Menekşe S, Ebinç S, Aksoy S, İmamoğlu Gİ, Altınbaş M, Çetin B, Uluç BO, Er Ö, Karadurmuş N, Erdoğan AP, Artaç M, Tanrıverdi Ö, Çiçin İ, Şendur MAN, Oktay E, Bayoğlu İV, Paydaş S, Aydıner A, Salim DK, Geredeli Ç, Yavuzşen T, Doğan M, Hacıbekiroğlu İ. Karacin C, et al. BMC Cancer. 2023 Feb 27;23(1):192. doi: 10.1186/s12885-023-10662-3. BMC Cancer. 2023. PMID: 36849943 Free PMC article. No abstract available.

Abstract

Background: There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based).

Methods: A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and ≥ 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy.

Results: The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0-14.0) months in the ET arm of group A, and 5.3 (3.9-6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8-7.7) months in the ET arm of group B, and 5.7 (4.6-6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5-8.0) months in the ET arm of group C and 4.0 (3.5-4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months.

Conclusion: Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET.

Keywords: Advanced breast cancer; Cyclin-dependent kinase; Endocrine treatment; Everolimus; Fulvestrant; Hormonotherapy; Palbociclib; Ribociclib.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Subsequent therapies and median progression free survivals of the patients
Fig. 2
Fig. 2
A. Progression free survival according to endocrine treatment in patients who take CDKi in first line. B. Progression free survival according to endocrine treatment in patients who take CDKi in second line. C. Progression free survival according to endocrine treatment in patients who take CDKi in ≥ 3rd line
See this image and copyright information in PMC

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