CDK4/6 inhibitors: taking the place of chemotherapy?

Abstract

The treatment landscape for advanced breast cancer has shifted dramatically over the past decade with the successive approvals of a multitude of targeted therapies. Specifically, CDK4/6 inhibitors have introduced a new treatment framework in the management of postmenopausal patients with hormone-receptor-positive, HER2-negative disease, who comprise the majority of patients with breast cancer. Clinical practice patterns have begun to veer away from a single-agent chemotherapy approach in the metastatic setting and towards upfront combination therapies with targeted agents in addition to endocrine therapy. Clearly delineating evidence, however, is needed to guide selection of one regimen over another in many cases. Endocrine treatment versus chemotherapy in postmenopausal women with hormone receptor-positive, HER2-negative, metastatic breast cancer: a systematic review and network meta-analysisIn the first-line or second-line setting, CDK4/6 inhibitors plus hormone therapies are better than standard hormone therapies in terms of progression-free survival. Moreover, no chemotherapy regimen with or without targeted therapy is significantly better than CDK4/6 inhibitors plus hormone therapies in terms of progression-free survival. Our data support treatment guideline recommendations involving the new combinations of hormone therapies plus targeted therapies as first-line or second-line treatments, or in both settings, in women with hormone-receptor-positive, HER2-negative metastatic breast cancer. Full-Text PDF