- A network meta-analysis finds that CDK4/6 inhibitors plus endocrine therapies (ET) are superior to ET alone for PFS in patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer.
- CDK4/6 inhibitors with ET are also superior to any chemotherapy with or without targeted therapy (CDK4/6 inhibitor or everolimus) for PFS.
Why this matters
- This is the first network meta-analysis of its kind to incorporate the latest clinical trials.
- Network meta-analysis of 140 studies (n=50,029) after search of PubMed, Embase, Cochrane Central Register of Clinical Trials, Web of Science, and international oncology conferences.
- Funding: None.
- The following therapies had better PFS than anastrozole alone:
- Palbociclib+letrozole (HR, 0.42; 95% credible interval [CrI], 0.25-0.70).
- Ribociclib+letrozole (HR, 0.43; 95% CrI, 0.24-0.77).
- Abemaciclib+anastrozole or letrozole (HR, 0.42; 95% CrI, 0.23-0.76).
- Palbociclib+fulvestrant (HR, 0.37; 95% CrI, 0.23-0.59).
- No chemotherapy or hormone therapy was better than palbociclib+letrozole for PFS.
- Paclitaxel+bevacizumab was better than palbociclib+letrozole in terms of the proportion of patients achieving an overall response (OR, 8.95; 95% CrI, 1.03-76.92).
- Unable to perform separate analyses for first-line, second-line, and subsequent lines of therapy.