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The CDK4/6 inhibitor in HR-positive advanced breast cancer: A systematic review and meta-analysis

Wu Ding1, Zhian Li, Caiyun Wang

  • 1Department of Oncological Surgery, Shaoxing Second Hostipal Department of Nephrology, Shaoxing Second Hostipal Department of Surgery, Shaoxing Keqiao Women & Children's Hospital, Shaoxing, China University of Southern California, Los Angeles, CA.

Medicine
|May 17, 2018
PubMed
Abstract

Insights

Cyclin-dependent kinases (CDKs) 4/6 inhibitors significantly benefit patients with advanced hormone receptor-positive/HER2-negative breast cancer. This meta-analysis confirms improved progression-free survival and response rates with CDK4/6 inhibitor combination therapy.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Recent randomized controlled trials (RCTs) demonstrate the safety and efficacy of cyclin-dependent kinases (CDKs) 4/6 inhibitors.
  • These inhibitors are used in combination therapy with letrozole or fulvestrant for advanced breast cancer patients progressing on endocrine therapy.

Purpose of the Study:

  • To conduct a meta-analysis evaluating the benefits of CDK4/6 inhibitors in treating hormone receptor-positive (HR-positive)/human epidermal growth factor receptor 2 negative (HER2-negative) advanced breast cancer.

Main Methods:

  • Systematic review and meta-analysis of data from MEDLINE, EMBASE, and Cochrane Library (January 1980–December 2017).
  • Included data from 6 RCTs involving 3182 patients.

Main Results:

  • CDK4/6 inhibitor group showed significantly longer progression-free survival (PFS) (hazard ratio = 0.51; P < .00001).
  • Improved objective response (risk rate = 1.53; P < .00001) and clinical benefit response (risk rate = 1.29; P = .0001) were observed.
  • Subgroup and sensitive analyses confirmed consistent benefits across subgroups, with stability in outcomes.

Conclusions:

  • CDK4/6 inhibitors significantly improve PFS in patients with HR-positive/HER2-negative advanced breast cancer.
  • These inhibitors enhance objective response and clinical benefit response in the studied patient population.

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