Reviews:
The CDK 4/6 inhibitor in HRpositive advanced breast cancer
Wu Ding1,*, Zhian Li1,*, Caiyun Wang2,*, Guodong Ruan1, Luping Chen4 and Chuanjian Tu3
1Department of Oncological Surgery, Shaoxing Second Hostipal, Shaoxing, China
2Department of Nephrology, Shaoxing Second Hostipal, Shaoxing, China
3Department of Surgery, Shaoxing Keqiao Women and Children’s Hospital, Keqiao, China
4University of Southern California, Los Angeles, California, USA
*These authors contributed equally to this work
Correspondence to:
Chuanjian Tu, email: [email protected]
Keywords: breast cancer; HR-positive/HER2-negative; CDK4/6 inhibitors; PFS; adverse events
Received: July 26, 2017 Accepted: February 26, 2018 Published:
ABSTRACT
Recently, several high-quality clinical randomized controlled trials have identified that cyclin-dependent kinases 4/6 inhibitors obtained a great safety and efficacy, which can be consequently applied as a combination therapy with letrozole or fulvestrant for women who had advanced breast cancer and progressed while receiving endocrine therapy. In this systemic review, we performed a meta-analysis to explore whether cyclin-dependent kinase 4/6 inhibitors had a significantly benefit to treating hormone receptor–positive/human epidermal growth factor receptor 2 negative advanced breast cancer. The data for meta-analysis were collected from MEDLINE, EMBASE and Cochrane Library from January 1980 to June 2017, and eventually 2689 patients from five randomized controlled trials were included. The result showed the cyclin-dependent kinase 4/6 inhibitor group had a longer progression-free survival (hazard ratio = 0.51; 95% confidence interval = 0.46–0.57, p < 0.00001), a better objective response (risk rate =1.53; 95% CI, 1.35–1.74, p < 0.00001), as well as a better clinical benefit response (risk rate = 1.29; 95% confidence interval = 1.13–1.47, p = 0.0001). Besides, subgroup analyses of progression-free according to stratification factors and other baseline characteristics confirmed a great performance of cyclin-dependent kinase 4/6 inhibitors across the all subgroups. And Sensitivity analysis showed that all outcomes were stable except Finn 2014 trail. In conclusion, cyclin-dependent kinase 4/6 inhibitors can significantly prolong the progression-free survival and improve the objective response and clinical benefit response among the patients with hormone receptor–positive/human epidermal growth factor receptor 2 negative advanced breast cancer.