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Cyclin-dependent Kinases 4/6 Inhibitors in Neuroendocrine Neoplasms: from Bench to Bedside
Maria João de Sousa1,2, Lorenzo Gervaso2,3, Monica Isabel Meneses-Medina2,4
1Medical Oncology Department, Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, IPO Coimbra, Coimbra, Portugal.
Purpose Of Review:
Cyclin-dependent kinases (CDKs) are key regulators that play an important role in cell division. Palbociclib, ribociclib and abemaciclib showed significant antitumor activity in several malignancies and, recently, also a myeloprotective effect for trilaciclib when added to chemotherapy. The purpose of this review is to highlight the current evidence for CDK4/6 inhibitors in neuroendocrine neoplasms (NENs).
Recent Findings:
Preclinical results showed a promising antitumor activity of CDK4/6 inhibitors in neuroendocrine tumors (NETs), but so far, the very few small clinical trials did not show a strong impact on progression free survival (PFS) and objective response in NETs. Meanwhile, the CDK4/6 inhibitor trilaciclib revealed significant effects in reducing chemotherapy-induced myelosuppression in small cell lung cancer (SCLC). Up to date, CDK4/6 inhibitors are still considered investigational in NETs as antitumor agents, whereas trilaciclib can be used in the routine clinical practice in extensive stage SCLC patients for reducing myelotoxicity of standard chemotherapy.
Insights
Cyclin-dependent kinase (CDK) 4/6 inhibitors show promise in neuroendocrine neoplasms (NENs). While antitumor effects are still under investigation, trilaciclib demonstrates significant myeloprotective benefits in small cell lung cancer (SCLC).
Area of Science:
- Oncology
- Cell Biology
- Pharmacology
Background:
- Cyclin-dependent kinases (CDKs) are critical regulators of cell division.
- CDK4/6 inhibitors like palbociclib, ribociclib, and abemaciclib have shown antitumor activity.
- Trilaciclib, a CDK4/6 inhibitor, exhibits myeloprotective effects in chemotherapy.
Purpose of the Study:
- To review current evidence on CDK4/6 inhibitors in neuroendocrine neoplasms (NENs).
Main Methods:
- Review of preclinical data and clinical trials involving CDK4/6 inhibitors in NENs.
- Examination of trilaciclib's role in mitigating chemotherapy-induced myelosuppression.
Main Results:
- Preclinical studies suggest CDK4/6 inhibitors have antitumor potential in neuroendocrine tumors (NETs).
- Limited clinical trials in NETs have not yet demonstrated significant improvements in progression-free survival or objective response.
- Trilaciclib effectively reduces chemotherapy-induced myelosuppression in small cell lung cancer (SCLC).
Conclusions:
- CDK4/6 inhibitors remain investigational for antitumor therapy in NENs.
- Trilaciclib is approved for routine use in extensive-stage SCLC to manage myelotoxicity.
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