scholarly journals Quality of life of therapies for hormone receptor positive advanced/metastatic breast cancer: Regulatory aspects and clinical impact in Europe

The Breast ◽  
2021 ◽  
Author(s):  
L. Moscetti ◽  
I. Sperdutia ◽  
A. Frassoldati ◽  
A. Musolino ◽  
C. Nasso ◽  
...  
2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 215-215 ◽  
Author(s):  
Myat M. Han ◽  
Kyaw Zin Thein ◽  
Myo Zaw ◽  
Aung Tun ◽  
Paul D'Cunha ◽  
...  

215 Background: Molecular heterogeneity in breast cancer has led to increasing attention in the role of cell cycle signaling especially the cyclins and their associated proteins, cycle-dependent kinases (CDK), in carcinogenesis and treatment resistance in hormone receptor-positive metastatic breast cancer. Many CDK 4/6 agents have been proven beneficial. Nevertheless, health-related quality of life from pain and fatigue remains a concern. We performed a systematic review and meta-analysis of randomized controlled trials (RCT) to determine these risks. Methods: MEDLINE, EMBASE databases and meeting abstracts from inception through June 2017 were queried. RCTs that mention back pain, pain in arms and legs, arthralgia and fatigue as adverse effects were incorporated in the analysis. Mantel-Haenszel method was used to calculate the estimated pooled risk ratio with 95% confidence interval (CI). Random effects model was applied. Results: A total of 2671 patients with hormone receptor-positive HER2-negative metastatic breast cancer from four phase 3 studies and one phase 2 study were eligible for analysis. The study arms used palbociclib-letrozole, palbociclib-fulvestrant, ribociclib-letrozole and abemaciclib-fulvestrant while the control arms utilized placebo in combination with letrozole or fulvestrant. The relative risk (RR) of all-grade back pain was 0.97 (95% CI: 0.81- 1.16; p = 0.76); all-grade pain in arms and legs was 0.98 (95% CI: 0.74- 1.30; p = 0.90); all-grade arthralgia was 0.98 (95% CI: 0.75- 1.27; p = 0.88); and all-grade fatigue was 1.35 (95% CI: 1.20- 1.52; p < 0.0001). The RR of high-grade back pain was 1.47 (95% CI: 0.51- 4.23; p = 0.46); high-grade pain in arms and legs was 0.12 (95% CI: 0.02- 0.73; p = 0.02); high-grade arthralgia was 1.14 (95% CI: 0.40- 3.26; p = 0.79); and high-grade fatigue was 3.06 (95% CI: 1.41- 6.61; p = 0.004). Conclusions: Patients on CDK4/6 inhibitor-based regimens experienced a significant increase in all-grades of fatigue with a relative risk of 3.06 for grade 3 and 4 fatigue whereas they noted a decrease in high-grade pain in the arms and legs favoring CDK 4/6 inhibitor based regimens.


Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2480
Author(s):  
Debora de Melo Gagliato ◽  
Antonio C Buzaid ◽  
Jose Manuel Perez-Garcia ◽  
Antonio Llombart ◽  
Javier Cortes

Treatment paradigms in advanced hormone receptor (HR)-positive breast cancer were substantially transformed with cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) approval. The addition of these drugs to endocrine treatment profoundly improved progression-free and overall survival. Additionally, other important endpoints, such as the response rate, time to chemotherapy, and a delay in quality of life deterioration, were positively impacted by CDK4/6 inhibitors’ addition to the treatment of advanced HR-positive breast cancer. This review article will summarize current knowledge on CDK4/6 inhibitors in clinical practice for advanced HR-positive metastatic breast cancer, as well as describe recent efforts to more precisely characterize mechanisms of sensitivity and resistance to these drugs, both on the molecular and clinical characterization level.


2021 ◽  
Vol 13 ◽  
pp. 175883592098765
Author(s):  
Raffaella Palumbo ◽  
Rosalba Torrisi ◽  
Federico Sottotetti ◽  
Daniele Presti ◽  
Anna Rita Gambaro ◽  
...  

Background: The CDK4/6 inhibitor palbociclib combined with endocrine therapy (ET) has proven to prolong progression-free survival (PFS) in women with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer (MBC). Few data are available regarding the efficacy of such a regimen outside the clinical trials. Patients and methods: This is a multicentre prospective real-world experience aimed at verifying the outcome of palbociclib plus ET in an unselected population of MBC patients. The primary aim was the clinical benefit rate (CBR); secondary aims were the median PFS, overall survival (OS) and safety. Patients received palbociclib plus letrozole 2.5 mg (cohort A) or fulvestrant 500 mg (cohort B). Results: In total, 191 patients (92 in cohort A, 99 in cohort B) were enrolled and treated, and 182 were evaluable for the analysis. Median age was 62 years (range 47–79); 54% had visceral involvement; 28% of patients had previously performed one treatment line (including chemotherapy and ET), 22.6% two lines and 15.9% three. An overall response rate of 34.6% was observed with 11 (6.0%) complete responses and 52 (28.6%) partial responses. Stable disease was achieved by 78 patients (42.9%) with an overall CBR of 59.8%. At a median follow-up of 24 months (range 6–32), median PFS was 13 months without significant differences between the cohorts. When analysed according to treatment line, PFS values were significantly prolonged when palbociclib-based therapy was administered as first-line treatment (14.0 months), to decrease progressively in second and subsequent lines (11.7 and 6.7 months, respectively). Median OS was 25 months, ranging from 28.0 months in 1st line to 18.0 and 13.0 months in 2nd and subsequent lines, respectively. Conclusions: Our data indicate that palbociclib plus ET is active and safe in HR+/HER2− MBC, also suggesting a better performance of the combinations in earlier treatment lines.


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