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A multicenter analysis of treatment patterns and clinical outcomes of subsequent therapies after progression on palbociclib in HR+/HER2− metastatic breast cancer

帕博西利布 医学 内科学 肿瘤科 依西美坦 转移性乳腺癌 卡培他滨 紫杉烷 化疗 长春瑞滨 乳腺癌 无进展生存期 癌症 妇科 三苯氧胺 顺铂 结直肠癌
作者
Yang Li,Wei Li,Chengcheng Gong,Yandong Zheng,Qi Ouyang,Ning Xie,Qing Qu,Rui Ge,Biyun Wang
出处
期刊:Therapeutic Advances in Medical Oncology [SAGE]
卷期号:13: 175883592110228-175883592110228 被引量:17
标识
DOI:10.1177/17588359211022890
摘要

Endocrine therapy and cyclin-dependent kinase (CDK) 4/6 inhibitors (CDK4/6i) are standard treatment options for hormone receptor positive (HR+)/human epidermal growth factor receptor 2 negative (HER2-) metastatic breast cancer (MBC). However, the efficacy of standard subsequent therapies after CDK4/6i-based treatment is unclear. This study aimed to examine physician practice patterns and treatment outcomes of subsequent therapies administered after progression on palbociclib therapy in clinical practice.The study included 200 patients with HR+/HER2- MBC who underwent subsequent treatments after progressing on palbociclib-based regimens in five Chinese institutions between August 2017 and April 2020. The treatment pattern, progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) were reported.A total of 200 patients were included, of whom 147 (73.5%) and 53 (26.5%) received subsequent chemotherapy and endocrine therapy, respectively. The frequently used monochemotherapy regimens were taxane (n = 29), capecitabine (n = 21), and vinorelbine (n = 17), while the endocrine therapy regimens were chidamide plus exemestane (n = 16) and everolimus plus exemestane (n = 9). The overall median PFS (mPFS) was 5.5 months, with no significant difference in mPFS between the chemotherapy and endocrine therapy groups (p = 0.669). However, among patients not sensitive to prior palbociclib treatment, those administered chemotherapy had significantly longer PFS than those administered endocrine therapy (p = 0.006). The mPFS with endocrine therapy after first-, second-, and subsequent-line palbociclib was 13.4, 3.1, and 4.1 months, respectively (p = 0.233); in contrast, the mPFS with chemotherapy was 7.2, 6.5, and 4.9 months after first-, second-, and subsequent-line palbociclib, respectively (p = 0.364). The median OS was not achieved. The ORR was 10.6% among the 198 patients included in the analysis.Physicians prefer chemotherapy over endocrine therapy for the treatment of patients with HR+/HER2- MBC who develop progression on palbociclib. Sensitivity to previous palbociclib treatment might be one of the indicators for predicting response to subsequent treatment.ClinicalTrials.gov identifier: NCT04517318.
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