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A Real-World Evidence Study of CDK4/6 Inhibitor Treatment Patterns and Outcomes in Metastatic Breast Cancer by

Jenna M Collins1, Beth L Nordstrom2, Kimmie K McLaurin3

  • 1Evidera, 500 Totten Pond Road, 5th Floor, Waltham, MA, 02451, USA. jenna.collins@evidera.com.

Oncology and Therapy
|July 26, 2021
PubMed
Abstract

Insights

Patients with germline BRCA (gBRCA)-mutated metastatic breast cancer (mBC) receiving CDK4/6 inhibitors showed poorer outcomes. This real-world study highlights an unmet need for optimized treatments in this gBRCAm mBC population.

Area of Science:

  • Oncology
  • Genetics
  • Pharmacology

Background:

  • Limited real-world data exist on CDK4/6 inhibitor effectiveness in germline BRCA (gBRCA)-mutated breast cancer.
  • Understanding treatment patterns is crucial for optimizing care in HR+/HER2- mBC patients.

Purpose of the Study:

  • To evaluate real-world treatment patterns and effectiveness of CDK4/6 inhibitors in patients with gBRCA-mutated HR+/HER2- metastatic breast cancer.
  • To compare outcomes between gBRCA-mutated (gBRCAm) and wild-type (gBRCAwt) or unknown gBRCA status patients.

Main Methods:

  • Retrospective analysis of adult patients with HR+/HER2- mBC treated with CDK4/6 inhibitors (2013-2018) from the Flatiron Health database.
  • Patients were classified based on known germline BRCA status (gBRCAm vs. gBRCAwt).
  • Time-to-first subsequent therapy or death (TFST) and overall survival (OS) were calculated and compared between groups.

Main Results:

  • Of 2968 patients, 859 had known gBRCA status (9.9% gBRCAm).
  • Median TFST was 10 months for gBRCAm vs. 10 months for gBRCAwt.
  • Median OS was 26 months for gBRCAm vs. 37 months for gBRCAwt.
  • Cox models indicated shorter TFST (sHR 1.24) and OS (sHR 1.50) for gBRCAm vs. gBRCAwt patients.

Conclusions:

  • Real-world outcomes with CDK4/6 inhibitors may be worse in gBRCAm mBC patients compared to gBRCAwt or unknown status.
  • Potential differences in tumor biology may underlie these observed outcomes.
  • There is an unmet need for optimized treatment selection and sequencing for patients with gBRCAm mBC.
Keywords:
CDK4/6 inhibitorsMetastatic breast cancerSurvivalTreatment patternsgBRCA mutation status

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