Cyclin-dependent kinase 4/6 inhibitors as first-line treatment for post-menopausal metastatic hormone receptor-positive breast cancer patients: a systematic review and meta-analysis of phase III randomized clinical trials

Breast Cancer : the Journal of the Japanese Breast Cancer Society
Allan Ramos-EsquivelDenis Ulises Landaverde

Abstract

To compare the efficacy and toxicity of the combination of cyclin-dependent kinase 4/6 (CDK 4/6) inhibitors and nonsteroidal aromatase inhibitors (AI) versus AI alone as first-line therapy for patients with advanced hormone receptor-positive breast cancer. Phase III randomized clinical trials (RCT) were identified after a systematic review of electronic databases. A random-effect model was used to determine the pooled hazard ratio (HR) for progression-free survival (PFS) using the inverse-variance method. The Mantel-Haenszel method was used to calculate the pooled odds ratio (OR) for overall response, clinical benefit rate and treatment-related side effects. Heterogeneity was measured using the tau-squared and I2 statistics. After a systematic search, three phase III RCT (n = 1827) were included. The use of CDK 4/6 inhibitors (abemaciclib, palbociclib, and ribociclib) in combination with an AI was significantly associated with longer PFS compared to the use of letrozole or anastrozole alone (HR: 0.57; 95% CI 0.50-0.65; p < 0.00001), with no significant heterogeneity among trials. Similarly, overall response rate and clinical benefit rate were higher for patients who received the combination therapy than for patients allocated t...Continue Reading

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Citations

Aug 17, 2018·The Journal of Clinical Endocrinology and Metabolism·Juliane LippertCristina L Ronchi
Jan 31, 2019·Cardiovascular Research·Mary BarberJoe-Elie Salem
Apr 23, 2019·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Shen ShenZhenfeng Duan
Nov 7, 2019·Journal of Cellular Biochemistry·Wen-Jing LiuSheng-Xiang Lin
May 22, 2018·Frontiers in Oncology·Azadeh NasrazadaniAdrian V Lee
Aug 14, 2020·Diagnostics·Michela PalleschiSara Bravaccini
Jul 25, 2018·Breast Cancer : the Journal of the Japanese Breast Cancer Society·Ayesha AftabSobia Tabassum
Sep 19, 2020·Expert Opinion on Therapeutic Patents·Peng-Fei WangHai-Liang Zhu
Oct 18, 2020·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Nicola GiesenMarie von Lilienfeld-Toal

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