CYCLIN-EPENDENT KINASES 4/6 INHIBITORS IN COMBINATION WITH AROMATASE INHIBITORS IN TREATMENT OF METASTATIC BREAST CANCER (clinical observation)

Abstract

It is known that a complete recovery in patients with generalized tumor is impossible, but the use of effective treatment regimens can significantly inhibit the development of the disease. The main goal of treatment of metastatic breast cancer is to increase overall survival, time to disease progression, improvethe quality of life, to prevent serious complications. In recent years, the standard of first−line hormone therapy in postmenopausal patients has been the use of aromatase inhibitors. Recently, a new class of drugs has emerged that can increase the effectiveness of hormone therapy, which significantly strengthens the position of this method in metastatic breast cancer. A clinical trial of PALOMA−2 and its findings are presented: the palbociclib + letrozole protocol as first−line therapy in postmenopausal patients with estrogen−positive Her2 new negative advanced breast cancer improves the objective response rate and clinical efficacy compared to letrozole monotherapy. The overall incidence of adverse responses was higher in patients treated with palbociclib + letrozole compared with placebo + letrozole. This clinical case demonstrates the possibility of long−term effective disease control in metastatic breast cancer. Literature data and personal experience show high efficacy of the combined protocol of hormone therapy and inhibitors of cyclin−dependent kinases 4/6. The use of such protocols is advisable in patients with multiple bone metastases, while achieving an effective reduction of pain. The use of such regimens is possible in patients with a low ECOG score who cannot tolerate chemotherapy with more severe toxicity. Key words: metastatic breast cancer, aromatase inhibitors, palbociclib.