Efficacy and safety in older patient subsets in studies of endocrine monotherapy versus combination therapy in patients with HR+/HER2- advanced breast cancer: a review

Breast Cancer Research and Treatment
Rachel A Freedman, Sara M Tolaney

Abstract

Prospective information regarding the tolerability and efficacy of endocrine therapy (ET) alone and in combination with targeted agents in older patients in the metastatic setting is limited. This review summarizes available trial data in this population. We searched PubMed for Phase 2 or 3 trials with age-stratified patient cohorts (≥ 65 vs. < 65 years in most studies) with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer treated with ET ± targeted agents. We identified 19 studies reporting 10 clinical trials. Efficacy was similar in age-stratified subsets. There was a reduced disease progression risk for ET + everolimus, palbociclib, or ribociclib versus ET alone. In the first-line setting, median progression-free survival (mPFS) in older patients was 8.5, 26.2 months, and not reached with letrozole + temsirolimus, palbociclib, and ribociclib, respectively, and in younger patients was 9.0, 18.8 months, and not reached, respectively. In the second-line setting, older patients had mPFS of 6.8 and 9.9 months with everolimus + exemestane and palbociclib + fulvestrant, respectively, and younger patients had mPFS of 8.1 and 9.5 months, respectively. Tolerability was w...Continue Reading

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Citations

Apr 30, 2019·Journal of the American Geriatrics Society·Allison MagnusonThuy Koll
Jun 23, 2019·International Journal of Molecular Sciences·Elizabeth VargheseDietrich Büsselberg
Aug 24, 2018·Frontiers in Oncology·Z Ping LinElena S Ratner
May 28, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Nicolò Matteo Luca BattistiAlistair Ring
Feb 2, 2022·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·M D Torregrosa-MaicasR Gironés-Sarrió

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