Optimizing therapeutic approaches for HR+/HER2- advanced breast cancer: clinical perspectives on biomarkers and treatment strategies post-CDK4/6 inhibitor progression

Cancer Drug Resistance, Год журнала: 2025, Номер unknown

Опубликована: Янв. 22, 2025

This review offers an expert perspective on biomarkers, CDK4/6 inhibitor efficacy, and therapeutic approaches for managing hormone receptor-positive (HR+), human epidermal growth factor receptor-negative (HER2-) advanced breast cancer (ABC), particularly after progression. Key trials have demonstrated that combining inhibitors with endocrine therapy (ET) significantly improves progression-free survival (PFS), median durations ranging from 14.8 to 26.7 months, overall (OS), reaching up 53.7 months. Actionable such as PIK3CA ESR1 mutations, emerged pivotal tools guide second-line treatment decisions, enabling the use of targeted therapies like alpelisib elacestrant emphasizing important role biomarkers in guiding selection therapy. overview aims provide clinicians a practical up-to-date framework inform decisions improve patient care context this challenging disease. Additionally, we emerging novel strategies address difficult clinical landscape.

Язык: Английский

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The effect of dose reduction of CDK4/6 inhibitors on survival in postmenopausal HR+ HER2-negative metastatic breast cancer

Expert Review of Anticancer Therapy, Год журнала: 2025, Номер unknown

Опубликована: Апрель 8, 2025

This study aimed to evaluate the effect of dose reduction CDK4/6 inhibitors on survival outcomes in postmenopausal patients with HR+ HER2-negative metastatic breast cancer (mBC). A retrospective cohort was conducted involving 164 mBC who received between 2021 and 2024. Clinical parameters were systematically analyzed. Progression-free (PFS) overall (OS) evaluated based status. Survival estimated using Kaplan-Meier method, independent prognostic factors identified through multivariate Cox regression analysis. The median age 61 years, a follow-up 23.5 months. PFS 23.3 months, while OS not reached. Dose occurred 45 (27%), exhibited significantly worse (PFS HR: 1.67, 95% CI: 1.02-2.72, p = 0.042; 2.54, 1.34-4.83, 0.004). liver metastases risk for shorter OS, treatment later lines associated PFS. reductions HER2- patients. Future biomarker-driven studies are needed guide personalized adjustments optimize efficacy.

Язык: Английский

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Fulvestrant Monotherapy After CDK4/6 Inhibitors in Metastatic Breast Cancer Patients: A Real-Life Experience

Cancers, Год журнала: 2024, Номер 16(24), С. 4179 - 4179

Опубликована: Дек. 15, 2024

Background: The treatment of hormone receptor positive (HR+), HER-2 negative metastatic breast cancer (MBC) has radically changed over the last few years. CDK4/6 inhibitors combined with endocrine therapy have become standard care as a front-line therapeutic approach, conferring significant improvement in progression-free survival and overall compared to traditional (ET) alone. However, wide administration these drugs clinical practice paved way for emergence new intrinsic acquired mechanisms resistance that seem compromise second-line effectiveness. In this context, fulvestrant monotherapy appears disqualified. Materials Methods: we evaluated population 30 women currently treated our oncology unit HR+/HER2- cancer, receiving 500 mg every 28 days after progression first-line CDK 4/6 aromatase inhibitors. Results: Of patients observed, 23 progressed median PFS 3.7 months (range 1–9.7 months). Conclusions: real-life experience suggests confers very poor disease control is quite an inadequate option. CDK4/6i beyond could possibly be considered more valid option, absence targetable mutations or newer, effective drugs.

Язык: Английский

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Identification and management of medical comorbidities in patients with HR+/HER2– metastatic breast cancer treated with CDK4/6 inhibitors: literature review and recommendations from experts in Spain opinion

Clinical Breast Cancer, Год журнала: 2024, Номер unknown

Опубликована: Дек. 1, 2024

Язык: Английский

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