Oral adverse effects of CDK4/6 inhibitors among breast cancer patients: a systematic review and meta-analysis

Long, Quanyi; Li, Xiaomin; Wu, Guanghui; Zhang, Jia; Li, Hongjiang

doi:10.21037/apm-21-1156

Cited by 5 publications

(2 citation statements)

References 25 publications

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“…Higher RRs were observed among patients receiving letrozole (8.50, 95% CI: 2.22–32.57) or palbociclib-containing regimens (2.44, 95% CI: 1.88–3.18). 40 …”

Section: Adverse Event Profile Of Cdk4/6 Inhibitorsmentioning

confidence: 99%

Expanding the Clinical Use of CDK4/6 Inhibitors in the Treatment of Hormone Receptor-Positive, HER2-Negative Breast Cancer from Metastatic Setting to Adjuvant Setting

Abdel‐Razeq¹,

Sharaf²

2022

DDDT

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More than two-thirds of patients with breast cancer present with hormone receptor (HR)-positive, human epidermal growth factor receptor-2 (HER2)-negative disease at their initial diagnosis. HR-positive breast cancer’s growth depends on Cyclin D1, a direct transcriptional target of estrogen receptors (ER). The recent introduction of cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors (palbociclib, ribociclib, and abemaciclib) has revolutionized the treatment of metastatic HR-positive, HER2-negative breast cancer in both endocrine-sensitive and endocrine-resistant settings and in both pre-and post-menopausal women. Multiple large randomized clinical trials had demonstrated improvement in progression-free survival (PFS) and, more recently, in overall survival (OS). Adjuvant endocrine therapy (ET) significantly reduces the risk of recurrence and death among patients with HR-positive early-stage breast cancer (EBC). However, up to 20% of these patients will experience local, regional or distal recurrences in the first ten years. Such resistance to ET motivated researchers to try CDK4/6 inhibitors in EBC, both in adjuvant and neoadjuvant settings. While many clinical trials are still ongoing, at least one study and two meta-analyses had shown beneficial results, based on which the US Food and Drug Administration had recently approved the use of one of these agents, abemaciclib, in combination with ET for the adjuvant therapy of patients with high-risk EBC. In this paper, we review the recently published and ongoing landmark clinical trials attempting to expand the use of CDK4/6 inhibitors, in combination with ET, in the adjuvant setting of EBC.

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“…Higher RRs were observed among patients receiving letrozole (8.50, 95% CI: 2.22–32.57) or palbociclib-containing regimens (2.44, 95% CI: 1.88–3.18). 40 …”

Section: Adverse Event Profile Of Cdk4/6 Inhibitorsmentioning

confidence: 99%

Expanding the Clinical Use of CDK4/6 Inhibitors in the Treatment of Hormone Receptor-Positive, HER2-Negative Breast Cancer from Metastatic Setting to Adjuvant Setting

Abdel‐Razeq¹,

Sharaf²

2022

DDDT

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“…Additionally, findings from a singular study (Cejuela et al, 2023) underscored diarrhea as a significant adverse reaction experienced by all patients, highlighting its clinical importance (Arbuckle et al, 2000). A meta-analysis regarding the risk of other side effects, such as stomatitis, demonstrated that especially palbociclib, among all CDK4/6i, could increase this risk impacting on patient adherence to the treatment (Long et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Digging in real-word electronic database for assessing CDK 4/6 inhibitors adherence in breast cancer patients from Romania

Turcu-Stiolica,

Udristoiu,

Subtirelu

et al. 2024

Front. Pharmacol.

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Introduction: It is imperative for patients to respect the prescribed treatments to achieve the anticipated clinical outcomes, including the outpatients receiving oral anti-cancer drugs such as selective cyclin-dependent kinase 4/6 inhibitors (CDK 4/6i). With the introduction of three CDK 4/6i drugs in the Romanian pharmaceutical market in 2018, our study aimed to evaluate medication adherence and the influencing factors among patients undergoing treatment with palbociclib, ribociclib, or abemaciclib for advanced or metastatic breast cancer.Methods: Medication adherence was assessed using the Proportion of Days Covered (PDC) method, and Spearman correlation analysis was conducted to explore the relationships between adherence, age, gender, and follow-up duration.Results: The study enrolled 330 breast cancer patients, with an average follow-up period of 14.6 ± 12.5 months for palbociclib, 10.6 ± 7.1 months for ribociclib, and 8.6 ± 6.4 months for abemaciclib-treated patients. A small proportion of patients demonstrated non-adherence: 12.8% for palbociclib, 14.6% for ribociclib, and 14.7% for abemaciclib. Among patients receiving palbociclib, there was no significant correlation between adherence, age (rho = 0.07, p = 0.35), or gender (rho = −0.144, p = 0.054). However, a significant correlation was found with the duration of follow-up (rho = −0.304, p < 0.0001). Similar results were observed for patients receiving ribociclib or abemaciclib. Most patients received combination therapy with letrozole (46%) and exemestane (13%) for palbociclib, letrozole (48%) and fulvestrant (19%) for ribociclib, and fulvestrant (39%) and letrozole (27%) for abemaciclib,Discussion: High adherence rates were observed among patients treated with CDK 4/6i drugs, with no significant differences noted among the three drugs in this class. However, the collected patient data was limited, lacking information on adverse reactions that could potentially lead to treatment discontinuation, as determined by the oncologist’s decision not to prescribe. Consequently, a comprehensive understanding of all factors contributing to the low adherence levels is hindered.

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Dermatologic toxicities to inhibitors of cyclin-dependent kinases CDK 4 and 6: An updated review for clinical practice

Sibaud,

Sollena

2023

Annales de Dermatologie et de Vénéréologie

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Oral adverse effects of CDK4/6 inhibitors among breast cancer patients: a systematic review and meta-analysis

Cited by 5 publications

References 25 publications

Expanding the Clinical Use of CDK4/6 Inhibitors in the Treatment of Hormone Receptor-Positive, HER2-Negative Breast Cancer from Metastatic Setting to Adjuvant Setting

Expanding the Clinical Use of CDK4/6 Inhibitors in the Treatment of Hormone Receptor-Positive, HER2-Negative Breast Cancer from Metastatic Setting to Adjuvant Setting

Digging in real-word electronic database for assessing CDK 4/6 inhibitors adherence in breast cancer patients from Romania

Dermatologic toxicities to inhibitors of cyclin-dependent kinases CDK 4 and 6: An updated review for clinical practice

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