在先进的HR-阳性/HER2-阴性BC患者中,一线Palbociclib,Ribociclib或Abemaciclib加上内分泌治疗的实际有效性比较:来自多中心PALMARES-2研究的结果
L Provenzano1, M V Dieci2, G Curigliano3
1Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; IFOM ETS, AIRC Institute of Molecular Oncology, Milan, Italy.
概括
在晚期乳腺癌患者中,abemaciclib和ribociclib的无进展生存率比palbociclib更好. 这些发现有助于指导选择循环林依赖性激酶4/6抑制剂 (CDK4/6is) 用于个性化治疗.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 循环素依赖性激酶4/6抑制剂 (CDK4/6is) 结合内分泌疗法 (ET) 是HR阳性/HER2阴性晚期乳腺癌 (aBC) 的标准一线治疗方法.
- 没有发表过palbociclib,ribociclib和abemaciclib的大型对比比较.
研究的目的:
- 为了比较一线Palbociclib,Ribociclib和Abemaciclib与ET联合治疗HR阳性/HER2阴性aBC的实际有效性.
- 为了确定三个CDK4/6之间的潜在疗效差异,基于患者子组.
主要方法:
- 一项多中心,观察性,基于人群的研究 (PALMARES-2) 包括1982名在2016年1月至2023年9月期间开始第一线治疗的患者.
- 主要终点是现实世界无进展生存期 (rwPFS).
- 使用多变量考克斯回归模型调整相关临床变量.
主要成果:
- 中位数rwPFS为34.1个月. 与palbociclib相比,abemaciclib和ribociclib表现出明显更好的rwPFS (分别为aHR0.76,P=0.004和aHR0.83,P=0.007).
- 亚组分析显示了差异性有效性:abemaciclib在新发转移性疾病和较差表现状态的患者中显示出优异的rwPFS.
- 根据更年期状态,内分泌敏感性,疾病亚型和转移模式,有效性有所不同.
结论:
- 帕尔博西基利布,里博西基利布和阿贝马西基利布在HR-阳性/HER2-阴性aBC中表现出明显的现实世界的有效性概况.
- 这些发现为临床医生提供了宝贵的见解,以根据患者个体特征和临床背景选择最佳的CDK4/6抑制剂.
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