在先进乳腺癌患者的第一线CDK4/6抑制剂进展后的选择
Xiaomeng Jia1, Kainan Wang1, Xueqing Wang1
1The Second Hospital of Dalian Medical University, Dalian, China.
对于对CDK4/6抑制剂耐药的高级激素受体阳性乳腺癌,CDK4/6抑制剂和富勒韦斯特兰的组合是最有效的二线治疗. 其他选择,如Bcl-2抑制剂加上富尔韦斯特兰特和选择性雌激素受体降解剂,显示出有前途.
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:
- 对于具有CDK4/6抑制剂 (CDK4/6i) 耐药性的先进激素受体阳性 (HR+) 乳腺癌的最佳二线治疗尚未确定.
- CDK4/6抑制剂彻底改变了HR+晚期乳腺癌的治疗方法,但耐药性需要有效的后续疗法.
研究的目的:
- 确定HR+晚期乳腺癌患者的最佳二线治疗方案,这些患者在使用CDK4/6抑制剂后已经进展.
- 通过网络元分析评估各种治疗方案的疗效.
- 通过子组分析,探索遗传背景和临床特征如何影响治疗疗效.
主要方法:
- 随机对照试验 (RCT) 的系统审查和贝叶斯网络元分析 (NMA).
- 在Medline,Embase和Cochrane图书馆搜索相关的RCT.
- 主要结局:无进展生存 (PFS);次要结局:整体生存 (OS),整体反应率 (ORR),临床益处率 (CBR). 小组分析的重点是内脏转移和ESR1突变.
主要成果:
- 分析包括19项试验 (6621名患者),其中14项研究 (3876名患者) 报告了CDK4/6i预处理人群.
- 结合CDK4/6抑制剂和富尔韦斯特兰特 (Ful),在CDK4/6i预先治疗HR+晚期乳腺癌中显示出优异的PFS.
- 对内脏转移和ESR1突变的亚组分析支持了CDK4/6i + Ful. 的疗效. Bcl-2 抑制剂 (Bcl-2i) + Ful 显示出有利的生存状况,而选择性雌激素受体降解剂 (SERD) 和 CDK4/6i + ET 对 ORR 和 CBR 分别有好处.
结论:
- CDK4/6抑制剂加上富勒韦斯特兰是CDK4/6i预治疗HR+晚期乳腺癌的最有效的二线治疗方法,特别是在患有内脏转移或ESR1突变的患者中.
- Bcl-2 抑制剂加上富尔韦斯特兰特和选择性雌激素受体降解剂代表了潜在的替代性二线策略.
更多相关视频
09:38Establishment and Characterization of Three Afatinib-resistant Lung Adenocarcinoma PC-9 Cell Lines Developed with Increasing Doses of Afatinib
Published on: June 26, 2019
10:33Development of Inhibitors of Protein-protein Interactions through REPLACE: Application to the Design and Development Non-ATP Competitive CDK Inhibitors
Published on: October 26, 2015
相关概念视频
Inhibition of Cdk Activity
Targeted Cancer Therapies
There are several types of targeted therapies against...
Tumor Progression
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
Combination Therapies and Personalized Medicine
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
Cancer-Critical Genes II: Tumor Suppressor Genes
When the function of certain critical genes, especially those involved in cell cycle regulation and cell growth signaling cascades, gets disrupted, it upsets the cell cycle progression. Such cells with unchecked cell cycles start proliferating uncontrollably and eventually develop into tumors.
Such genes that act...
Treatment Resistant Cancers
