- A meta-analysis finds that CDK4/6 inhibitors+endocrine therapy (ET) yields improved OS in subgroups of patients with hormone receptor-positive (HR+)/HER2− metastatic breast cancer.
Why this matters
- Authors recommend that CDK4/6 inhibition+ET should be "preferred over" ET alone for most clinically relevant subgroups, such as those with visceral metastases and older subgroups.
- Meta-analysis of 6 phase 2/3 randomized controlled trials (RCTs; N=3421) of palbociclib, ribociclib, or abemaciclib+ET vs ET alone.
- Funding: None.
- With CDK4/6+ET vs ET alone, OS benefit (HRs; 95% CIs) was seen in patients:
- Without visceral metastases: 0.68 (0.54-0.85).
- With visceral metastases: 0.76 (0.65-0.89).
- With ≥3 metastatic sites: 0.75 (0.60-0.94).
- With endocrine-resistant disease: 0.79 (0.67-0.93).
- With endocrine-sensitive disease: 0.73 (0.61-0.88).
- Aged ≥65 years: 0.71 (0.53-0.95).
- Who were postmenopausal: 0.75 (0.66-0.86)
- Who were pre/perimenopausal: 0.76 (0.60-0.96).
- Who were chemotherapy-naive: 0.72 (0.55-0.93).
- Small number of trials.
- Heterogeneity across trials.