认知功能在内分泌治疗期间与或没有循环素依赖的激酶4/6抑制剂用于晚期乳腺癌
Maryse J Luijendijk1, Philippe R Lee Meeuw Kjoe1, Noor Wortelboer2
1Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Cancer
|December 10, 2025
概括
晚期乳腺癌患者接受与CDK4/6抑制剂或不含CDK4/6抑制剂的内分泌治疗的认知功能没有出现小组下降,但小部分患者经历了有意义的认知下降. 这种下降发生不论CDK4/6抑制剂的使用.
科学领域:
- 在瘤学瘤学.
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 乳腺癌的内分泌疗法可能会对认知功能产生负面影响.
- 循环素依赖性激酶4/6抑制剂 (CDK4/6i) 在乳腺癌治疗中被广泛使用.
- 评估内分泌治疗与CDK4/6i结合的认知效应至关重要.
研究的目的:
- 评估先进乳腺癌患者的第一线内分泌治疗与芳酶抑制剂,有或没有CDK4/6抑制剂的认知效应.
- 为了比较接受芳酶抑制剂单独与CDK4/6抑制剂组合治疗的患者之间的9个月的认知功能变化.
- 为了确定CDK4/6抑制剂是否会加剧这种患者群体的认知衰退.
主要方法:
- 在SONIA试验中,HR+/HER2-晚期乳腺癌患者随机被分为使用或不使用CDK4/6i的芳酶抑制剂治疗.
- 在基线和9个月使用阿姆斯特丹认知扫描评估认知功能.
- 认知表现与匹配的无癌症对照进行了比较,分析了群体层面的变化和个体临床上有意义的下降率.
主要成果:
- 在基线,患者在所有认知领域的表现明显低于对照组.
- 在9个月的时间里,在任何治疗组中都没有观察到显著的群体级认知衰退.
- 虽然小组水平的功能保持稳定,但小部分患者 (14-16%) 经历了临床上有意义的认知衰退,这一比例明显高于对照组,超过了假阳性率.
结论:
- 患有HR+/HER2-晚期乳腺癌的患者在诊断时表现出认知障碍.
- 用芳酶抑制剂进行一线内分泌治疗,有或没有CDK4/6抑制剂,在9个月内不会导致群体水平的认知能力下降.
- 一小部分患者经历了临床上有意义的认知衰退,不管是添加了CDK4/6抑制剂,这突显了个性化监测的必要性.
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