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Outcome of Everolimus-Based Therapy in Hormone-Receptor-Positive Metastatic Breast Cancer Patients After Progression
Ajay Dhakal1, Roby Antony Thomas2, Ellis G Levine3
1Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.
Background:
Despite the approval of mTOR inhibitor everolimus and CDK4/6 inhibitors in the management of hormone-receptor-positive HER2 non-amplified metastatic breast cancer (HR+ HER2-MBC), the optimal sequence of therapy is unclear. There are no clinical data on efficacy of everolimus in HR+ HER2-MBC after cancer progresses on CDK4/6 inhibitors.
Objective:
The objective of this study is to find the efficacy of everolimus in HR+ HER2-MBC after they progress on a CDK4/6 inhibitor palbociclib.
Methods:
This is a retrospective, 2-institute review of HR+ HER2-MBC from Jan 2015 to March 2018 treated with everolimus after progression on palbociclib. Primary end point was median progression-free survival (PFS), secondary end points objective response rate (ORR), clinical benefit ratio (CBR), and overall survival (OS).
Results:
Out of 41 women with median age 61 years (33, 87) enrolled, 66% had received adjuvant systemic therapy, 61% had visceral disease, and 95% had prior nonsteroidal aromatase inhibitors. About 83% women had 3 or more chemotherapy or hormonal therapies prior to everolimus. Kaplan-Meier estimates showed a median PFS of 4.2 months (95% confidence interval [CI]: 3.2-6.2). The median OS was 18.7 months (95% CI 9.5 to not reached). Objective response rate and CBR were both 17.1%.
Conclusion:
Everolimus was associated with modest PFS and ORR in HR+ HER2-MBCs postprogression on palbociclib.
Insights
Everolimus demonstrated modest efficacy in hormone-receptor-positive, HER2-negative metastatic breast cancer (HR+ HER2-MBC) after progression on palbociclib. This study provides insights into treatment sequencing for advanced HR+ HER2-MBC patients.
Area of Science:
- Oncology
- Pharmacology
Background:
- Hormone-receptor-positive, HER2-negative metastatic breast cancer (HR+ HER2-MBC) treatment landscape.
- Limited data on sequential therapy after CDK4/6 inhibitor failure.
Purpose of the Study:
- Evaluate everolimus efficacy in HR+ HER2-MBC post-palbociclib progression.
- Assess progression-free survival (PFS), objective response rate (ORR), and overall survival (OS).
Main Methods:
- Retrospective review of 41 HR+ HER2-MBC patients treated with everolimus post-palbociclib.
- Data collected from Jan 2015 to March 2018.
- Primary endpoint: median PFS; secondary endpoints: ORR, clinical benefit ratio (CBR), OS.
Main Results:
- Median PFS of 4.2 months (95% CI: 3.2-6.2).
- Median OS of 18.7 months (95% CI: 9.5 to not reached).
- ORR and CBR were both 17.1%.
Conclusions:
- Everolimus shows modest PFS and ORR in HR+ HER2-MBC after palbociclib failure.
- Suggests a potential role for everolimus in later lines of therapy.
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