Academic Journal
Cyclin-dependent kinase 4 and 6 inhibitors in combination with neoadjuvant endocrine therapy in estrogen receptor-positive early breast cancer: a systematic review and meta-analysis.
| العنوان: | Cyclin-dependent kinase 4 and 6 inhibitors in combination with neoadjuvant endocrine therapy in estrogen receptor-positive early breast cancer: a systematic review and meta-analysis. |
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| المؤلفون: | Guan, Yumei, Shen, Guoshuang, Fang, Qianqian, Xin, Yuanfang, Huo, Xingfa, Li, Jinming, Zhao, Fuxing, Ren, Dengfeng, Liu, Zhen, Li, Zitao, Zhao, Jiuda |
| المصدر: | Clinical & Experimental Medicine; Jun2023, Vol. 23 Issue 2, p245-254, 10p |
| مصطلحات موضوعية: | CYCLIN-dependent kinases, EPIDERMAL growth factor receptors, ESTROGEN, METASTATIC breast cancer, HORMONE therapy, CYCLIN-dependent kinase inhibitors, NEOADJUVANT chemotherapy, BREAST cancer |
| مستخلص: | The combination of cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors and endocrine treatment has benefited patients with estrogen receptor-positive/human epidermal growth factor receptor 2-negative (ER + /HER2-) metastatic breast cancer; however, its effects in the neoadjuvant setting for ER + /HER2- early breast cancer (EBC) are unclear. Systematic searches were performed in PubMed, Embase, Cochrane Library, and major oncological meetings for trials of CDK4/6 inhibitors plus neoadjuvant endocrine treatment (NET) vs. NET/neoadjuvant chemotherapy (NACT) alone up to January 30, 2021. We assessed the efficacy of CDK4/6 inhibitors plus NET vs. NET/NACT alone in ER + /HER2- EBC. Six studies that included 803 patients treated with CDK4/6 inhibitors plus NET vs. NET/NACT alone were used. Compared with NET/NACT alone, CDK4/6 inhibitors plus NET increased the complete cell cycle arrest (CCCA) rate (OR, 9.00; 95% CI, 5.42–14.96; P < 0.001). Nonsignificant differences between CDK4/6 inhibitors and NET/NACT alone occurred in the preoperative endocrine prognostic index (PEPI)-0 rate (OR, 1.13; 95% CI, 0.59–2.18; P = 0.71), pathological complete response (pCR) rate (OR, 0.75; 95% CI, 0.13–4.29; P = 0.74), objective response rate (ORR) (OR, 0.70; 95% CI, 0.21–2.29; P = 0.55), and disease control rate (DCR) (OR, 1.16; 95% CI, 0.47–2.89; P = 0.74). CDK4/6 inhibitors plus NET indicated a high risk of neutropenia (OR, 56.43; 95% CI, 15.76–202.11; P < 0.001) as an adverse effect (AE) and elevated alanine aminotransferase (ALT) level (OR, 15.30; 95% CI, 2.02–115.98; P = 0.008) as grade 3/4 AEs. Compared with NET/NACT alone, CDK4/6 inhibitors plus NET increased CCCA rate in ER + /HER2- EBC patients. CDK4/6 inhibitors plus NET did not substantially improve the PEPI-0 rate, pCR rate, ORR, or DCR. The combination increased the risk of neutropenia and elevated ALT levels. In the neoadjuvant setting, addition of CDK4/6 inhibitors to NET may be an option for treating ER + /HER2- EBC. [ABSTRACT FROM AUTHOR] |
| Copyright of Clinical & Experimental Medicine is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| قاعدة البيانات: | Complementary Index |
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