CDK4/6 inhibitors in metastatic breast cancer, a comparison of toxicity and efficacy across agents in a real-world dataset
CDK4/6 inhibitors (ribociclib, palbociclib and abemaciclib) are 1st line therapy in metastatic breast cancer (MBC). No comparative data exists between agents regarding toxicity or efficacy. A retrospective study was performed at our tertiary referral centre evaluating patients on a CDK4/6 inhibitor...
Saved in:
Published in | Journal of oncology pharmacy practice p. 10781552231163121 |
---|---|
Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
England
01.12.2023
|
Subjects | |
Online Access | Get more information |
Cover
Loading…
Abstract | CDK4/6 inhibitors (ribociclib, palbociclib and abemaciclib) are 1st line therapy in metastatic breast cancer (MBC). No comparative data exists between agents regarding toxicity or efficacy.
A retrospective study was performed at our tertiary referral centre evaluating patients on a CDK4/6 inhibitor for MBC between July 2017 and December 2021. Toxicity was evaluated along with variability in full blood counts and liver function over the first 12 weeks of therapy.
Two hundred and seventeen patients were treated (palbociclib 59%, abemaciclib 25% and ribociclib 16%). 86% received the agent as 1st line therapy. Most patients were white women with a median age of 61 years (32-95) and ECOG 0/1. Twelve patients were switched to an alternative CDK4/6 inhibitor due to toxicity and two did not tolerate this. Toxicity profiles of agents were consistent with published trials. However, there was greater overlap in hepatitis, diarrhoea and bone marrow suppression. Blood results indicated a minimum of four weeks treatment before development of neutropenia. Forty percent of patients went onto have subsequent lines of therapy. The progression-free survival per agent was palbociclib 27.9 months (95% CI 23-32.5), ribociclib 29 months (95% CI 21.5-37.0) and abemaciclib 20.6 months (95% CI 15.0-26.0). The overall survival was palbociclib 38.0 months (95% CI 33.5-42.5), ribociclib 33.9 months (95% CI 26.7-41.1) and abemaciclib 27.3 months (95% CI 22.5-32.1).
Toxicity across CDK4/6 inhibitors overlaps. The optimal sequence of therapies post CDK4/6 inhibitors remains unknown but rechallenge with an alternative agent is possible. |
---|---|
AbstractList | CDK4/6 inhibitors (ribociclib, palbociclib and abemaciclib) are 1st line therapy in metastatic breast cancer (MBC). No comparative data exists between agents regarding toxicity or efficacy.
A retrospective study was performed at our tertiary referral centre evaluating patients on a CDK4/6 inhibitor for MBC between July 2017 and December 2021. Toxicity was evaluated along with variability in full blood counts and liver function over the first 12 weeks of therapy.
Two hundred and seventeen patients were treated (palbociclib 59%, abemaciclib 25% and ribociclib 16%). 86% received the agent as 1st line therapy. Most patients were white women with a median age of 61 years (32-95) and ECOG 0/1. Twelve patients were switched to an alternative CDK4/6 inhibitor due to toxicity and two did not tolerate this. Toxicity profiles of agents were consistent with published trials. However, there was greater overlap in hepatitis, diarrhoea and bone marrow suppression. Blood results indicated a minimum of four weeks treatment before development of neutropenia. Forty percent of patients went onto have subsequent lines of therapy. The progression-free survival per agent was palbociclib 27.9 months (95% CI 23-32.5), ribociclib 29 months (95% CI 21.5-37.0) and abemaciclib 20.6 months (95% CI 15.0-26.0). The overall survival was palbociclib 38.0 months (95% CI 33.5-42.5), ribociclib 33.9 months (95% CI 26.7-41.1) and abemaciclib 27.3 months (95% CI 22.5-32.1).
Toxicity across CDK4/6 inhibitors overlaps. The optimal sequence of therapies post CDK4/6 inhibitors remains unknown but rechallenge with an alternative agent is possible. |
Author | Chu, Teresa Buller, William Pallan, Lalit Khoja, Leila |
Author_xml | – sequence: 1 givenname: William surname: Buller fullname: Buller, William organization: College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK – sequence: 2 givenname: Lalit surname: Pallan fullname: Pallan, Lalit organization: Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK – sequence: 3 givenname: Teresa surname: Chu fullname: Chu, Teresa organization: Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK – sequence: 4 givenname: Leila orcidid: 0000-0002-9111-3080 surname: Khoja fullname: Khoja, Leila organization: Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36945886$$D View this record in MEDLINE/PubMed |
BookMark | eNo1kLlOAzEYhC0EIgc8AA3yA7DEx67tLVE4RSQakOii3xcYZe3INoLw9Kw4qvlmiq-YGdqPKTqETig5p1TKBSVS0a5jjFMqOGV0D01pK2VDevY8QbNS3gghSjJ1iCZc9G2nlJiir-XlfbsQOMTXoENNuYyIB1ehVKjBYJ3diNhANC6fYcAmDVvIoaSIk8c1fQYT6g5DtNh5HwyYsZicSsHw4mL9EQIeNZvmI-WNxRZGu6tH6MDDprjjv5yjp-urx-Vts3q4uVterBrDhaqNEq101krSeaUJp07ytgVpvfBa9VJ5qseBcQd960EIz7TxTgtDLdPcCTZHp7_e7bsenF1vcxgg79b_J7BvKstgbg |
CitedBy_id | crossref_primary_10_14309_crj_0000000000001253 crossref_primary_10_17650_1994_4098_2024_20_1_64_81 crossref_primary_10_1053_j_seminoncol_2024_01_002 crossref_primary_10_58600_eurjther2151 |
ContentType | Journal Article |
DBID | NPM |
DOI | 10.1177/10781552231163121 |
DatabaseName | PubMed |
DatabaseTitle | PubMed |
DatabaseTitleList | PubMed |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database |
DeliveryMethod | no_fulltext_linktorsrc |
Discipline | Medicine Pharmacy, Therapeutics, & Pharmacology |
EISSN | 1477-092X |
ExternalDocumentID | 36945886 |
Genre | Journal Article |
GroupedDBID | --- .2E .2J .2N 01A 0R~ 18M 1~K 29L 31R 31U 31X 31Z 36B 4.4 54M 5GY 5VS 6PF 8R4 8R5 AACMV AACTG AAEWN AAGMC AAJPV AAJQC AAKGS AAMGE AAPEO AARDL AATAA AATBZ AAUAS AAWTL ABAWP ABCCA ABHQH ABJNI ABLUO ABPNF ABQKF ABQXT ABVFX ACARO ACDXX ACFEJ ACGFO ACGFS ACGZU ACIWK ACJER ACJTF ACLFY ACLZU ACOXC ACPRK ACROE ACSIQ ACTQU ACUAV ACUIR ACXKE ACXMB ADBBV ADRRZ AECGH AEDTQ AEKYL AEPTA AERKM AESZF AEUHG AEUIJ AEWDL AEWHI AFKRG AFMOU AFQAA AFRAH AGKLV AGWFA AGWNL AHMBA AIOMO AJUZI AJXAJ ALIPV ALKWR ALMA_UNASSIGNED_HOLDINGS ALTZF AMCVQ ANDLU ARTOV AUTPY AUVAJ AYAKG B3H B8R B8Z B94 BBRGL BDDNI BKIIM BPACV BSEHC BWJAD C45 CS3 DB0 DC. DF. DF0 DO- DV7 DV9 EBS ESX EX3 F5P FHBDP GROUPED_SAGE_PREMIER_JOURNAL_COLLECTION HF~ HZ~ J8X JCYGO K.F M4V N9A NPM O9- OVD P.B P2P Q1R Q2X Q7L Q7U Q83 ROL S01 SCNPE SDB SFC SFK SFT SGO SGR SGV SGZ SHG SNB SPJ SPQ SPV STM TEORI WOW |
ID | FETCH-LOGICAL-c368t-8647edd705f8b031e7344a7df6fb8978f1b34423ea94fa66f2bcfeb6c1d2b3e62 |
IngestDate | Wed Oct 16 00:39:21 EDT 2024 |
IsPeerReviewed | true |
IsScholarly | true |
Keywords | toxicity Metastatic breast cancer CDK4/6 inhibitor |
Language | English |
LinkModel | OpenURL |
MergedId | FETCHMERGED-LOGICAL-c368t-8647edd705f8b031e7344a7df6fb8978f1b34423ea94fa66f2bcfeb6c1d2b3e62 |
ORCID | 0000-0002-9111-3080 |
PMID | 36945886 |
ParticipantIDs | pubmed_primary_36945886 |
PublicationCentury | 2000 |
PublicationDate | 2023-12-01 |
PublicationDateYYYYMMDD | 2023-12-01 |
PublicationDate_xml | – month: 12 year: 2023 text: 2023-12-01 day: 01 |
PublicationDecade | 2020 |
PublicationPlace | England |
PublicationPlace_xml | – name: England |
PublicationTitle | Journal of oncology pharmacy practice |
PublicationTitleAlternate | J Oncol Pharm Pract |
PublicationYear | 2023 |
SSID | ssj0008728 |
Score | 2.3793483 |
Snippet | CDK4/6 inhibitors (ribociclib, palbociclib and abemaciclib) are 1st line therapy in metastatic breast cancer (MBC). No comparative data exists between agents... |
SourceID | pubmed |
SourceType | Index Database |
StartPage | 10781552231163121 |
Title | CDK4/6 inhibitors in metastatic breast cancer, a comparison of toxicity and efficacy across agents in a real-world dataset |
URI | https://www.ncbi.nlm.nih.gov/pubmed/36945886 |
hasFullText | |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwELa2IFW9VFBe5aU5oF6ygU2c2M4RFVBFadXDVuqtsh2bpirZFbsr0f4afirjRzbL8uYSRfbGWvn7ZI_H880Q8qLkWte47KUCd4-0kNqmciR1mqtKUqmcmNE59I-O2cFp8f6sPBsMvq5ELS3m6qW--amu5H9QxTbE1alk_wHZ5aDYgO-ILz4RYXz-Fcb7bw4L_JolTXvRqMYXzmlaVxVaOqFQoxPlYs7nLrRLx0jNGHUeKw-i6fml0c4Sdw504_JJuPrv0m-eifzo9W84pExwoKvU51dNXFTpzHzn1F-xayetDnmdpiEr9vVSibU8-i86_WH09vT3WEjKoIVwx4M-9GDhaWU-m9lyFzm8mFx6w_eDaa7kqvMipyuBICYsuAXn6ajyJdW7RTRzCYhKNAxphtZiFhTUPy71_rL5t79FtKafPPaUVU6Sy_7cu5Z9u-vaIBtcuNIgx84bFHd6wXMRb8ozn8Jg7b9skc3u-7VTi7dexnfIdoQHXgcO3SUD0-6QzaMYWLFD9k4iWEMY94q82RD24KRPbn59j9w4zr1i0DMOX6FnHATGQWDcECT0fIOJhY5vgHyDjm8Q-AaBb25ACT3fIPLtPjl993a8f5DG-h2ppkzMU8EKbuqaj0orFG4ehtOikLy2zCpRcWEzhQ05NbIqrGTM5kpbo5jO6lxRw_IH5FY7ac0jAnjO13ltlaotnn9LLSzOsRSmpplUaLbvkodhes-nIUnLeTfxj3_Z84Rs9ZR8Sm5bXBXMMzQx5-q5x_kbhFd8GA |
link.rule.ids | 780 |
linkProvider | National Library of Medicine |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=CDK4%2F6+inhibitors+in+metastatic+breast+cancer%2C+a+comparison+of+toxicity+and+efficacy+across+agents+in+a+real-world+dataset&rft.jtitle=Journal+of+oncology+pharmacy+practice&rft.au=Buller%2C+William&rft.au=Pallan%2C+Lalit&rft.au=Chu%2C+Teresa&rft.au=Khoja%2C+Leila&rft.date=2023-12-01&rft.eissn=1477-092X&rft.spage=10781552231163121&rft_id=info:doi/10.1177%2F10781552231163121&rft_id=info%3Apmid%2F36945886&rft_id=info%3Apmid%2F36945886&rft.externalDocID=36945886 |