Implementation of CDK4/6 Inhibitors and its Influence on the Treatment Landscape of Advanced Breast Cancer Patients - Data from the Real-World Registry PRAEGNANT

被引：12

作者：

Engler, Tobias ^{[1
]}

Fasching, Peter A. ^{[2
]}

Lueftner, Diana ^{[3
,4
]}

Hartkopf, Andreas D. ^{[5
]}

Mueller, Volkmar ^{[6
]}

Kolberg, Hans-Christian ^{[7
]}

Hadji, Peyman ^{[8
,9
]}

Tesch, Hans ^{[10
]}

Haeberle, Lothar ^{[2
,11
]}

Ettl, Johannes ^{[12
]}

Wallwiener, Markus ^{[13
]}

Beckmann, Matthias W. ^{[2
]}

Hein, Alexander ^{[2
]}

Belleville, Erik ^{[14
]}

Uhrig, Sabrina ^{[2
]}

Wimberger, Pauline ^{[15
,16
,17
,18
,19
,20
,21
]}

Hielscher, Carsten ^{[22
]}

Kurbacher, Christian M. ^{[23
]}

Wuerstlein, Rachel ^{[24
,25
]}

Untch, Michael ^{[26
]}

Taran, Florin-Andrei ^{[27
]}

Enzinger, Hans-Martin ^{[28
]}

Krabisch, Petra ^{[29
]}

Welslau, Manfred ^{[30
]}

Maasberg, Michael ^{[31
]}

Hempel, Dirk ^{[32
]}

Lux, Michael P. ^{[33
,34
,35
]}

Michel, Laura L. ^{[36
]}

Janni, Wolfgang ^{[5
]}

Wallwiener, Diethelm ^{[1
]}

Brucker, Sara Y. ^{[1
]}

Fehm, Tanja N. ^{[37
]}

Schneeweiss, Andreas ^{[36
]}

机构：

[1] Univ Tubingen, Dept Obstet & Gynecol, Tubingen, Germany

[2] Friedrich Alexander Univ Erlangen Nuremberg, Erlangen Univ Hosp, Comprehens Canc Ctr Erlangen EMN, Dept Gynecol & Obstet, Univ Str 21-23, D-91054 Erlangen, Germany

[3] Immanuel Hosp Mark Schweiz, Brandenburg, Germany

[4] Med Univ Brandenburg Theodor Fontane, Brandenburg, Germany

[5] Ulm Univ Hosp, Dept Gynecol & Obstet, Ulm, Germany

[6] Hamburg Eppendorf Univ Med Ctr, Dept Gynecol, Hamburg, Germany

[7] Marienhosp Bottrop, Dept Gynecol & Obstet, Bottrop, Germany

[8] Frankfurt Ctr Bone Hlth, Marburg, Germany

[9] Philips Univ Marburg, Marburg, Germany

[10] Bethanien Hosp, Oncol Practice, Frankfurt, Germany

[11] Erlangen Univ Hosp, Dept Gynecol & Obstet, Biostat Unit, Erlangen, Germany

[12] Tech Univ Munich, Dept Obstet & Gynecol, Klinikum Rechts Isar, Munich, Germany

[13] Heidelberg Univ Hosp, Dept Obstet & Gynecol, Heidelberg, Germany

[14] ClinSol GmbH & Co KG, Wurzburg, Germany

[15] Tech Univ Dresden, Dept Gynecol & Obstet, Carl Gustav Carus Fac Med, Dresden, Germany

[16] Tech Univ Dresden, Univ Hosp, Dresden, Germany

[17] Natl Ctr Tumor Dis NCT, Dresden, Germany

[18] German Canc Res Ctr, Heidelberg, Germany

[19] Tech Univ Dresden, Carl Gustav Carus Fac Med, Dresden, Germany

[20] Helmholtz Zentrum Dresden Rossendorf HZDR, Dresden, Germany

[21] German Canc Consortium DKTK, Dresden, Germany

[22] Onkol Zentrum Stralsund, Gynakol Kompetenzzentrum, Stralsund, Germany

[23] Gynecol Ctr Bonn, Dept Gynecol & Gynecol Oncol, Friedenspl, Bonn, Germany

[24] Munich Univ Hosp, Breast Ctr, Dept Gynecol & Obstet, Munich, Germany

[25] Munich Univ Hosp, CCC Munich, Munich, Germany

[26] Helios Clin Berlin Buch, Dept Gynecol & Obstet, Berlin, Germany

[27] Freiburg Univ Hosp, Dept Obstet & Gynecol, Freiburg, Germany

[28] Klinikum Bamberg, Sozialstiftung Bamberg, Dept Gynecol & Obstet, Bamberg, Germany

[29] Klinikum Chemnitz gGmbH, Dept Gynecol & Obstet, Chemnitz, Germany

[30] Onkol Aschaffenburg, Aschaffenburg, Germany

[31] MVZ Hamatol Onkol Mayen Koblenz GmbH, Mayen, Germany

[32] Onkol Zentrum Donauworth, Donauworth, Germany

[33] Frauenklin St Louise, Dept Gynecol & Obstet, Paderborn, Germany

[34] St Josefs Hosp, Frauenklin, Salzkotten, Germany

[35] St Vincenz Krankenhaus GmbH, Kooperat Brustzentrum Paderborn, Paderborn, Germany

[36] Heidelberg Univ Hosp, Natl Ctr Tumor Dis, German Canc Res Ctr DKFZ, Heidelberg, Germany

[37] Dusseldorf Univ Hosp, Dept Gynecol & Obstet, Dusseldorf, Germany

来源：

GEBURTSHILFE UND FRAUENHEILKUNDE | 2022年 / 82卷 / 10期

关键词：

advanced breast cancer; real world data; chemotherapy; CDK4/6; inhibitor; endocrine treatment; ENDOCRINE THERAPY; PALBOCICLIB; RIBOCICLIB; SURVIVAL; FULVESTRANT; LETROZOLE; ABEMACICLIB; COMBINATION; PROGRESSION; PATTERNS;

D O I：

10.1055/a-1880-0087

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Background Comprehensive data from prospective clinical trials have led to a high level of evidence establishing CDK4/6 inhibitors in combination with endocrine treatment (CDK4/6i + ET) as a standard for the treatment of HER2-negative, hormone receptor-positive (HER2- HR+) breast cancer patients in the first-line advanced therapy setting. Data on patient populations that have been treated in the real-world setting may provide an insight into changes of patient characteristics and prognosis over time. Methods The data were extracted from the prospective real-world registry PRAEGNANT (NCT02338167). Patients had to have HER2- HR+ advanced breast cancer in the first-line metastatic setting. The chosen therapies were described as well as progression-free survival (PFS) and overall survival (OS) in relation to the given therapies and time periods during which they were indicated. Results CDK4/6 inhibitors have been rapidly implemented since their introduction in November 2016. In recent years (2018-2022), about 70-80% of the patient population have been treated with CDK4/6 inhibitors, while endocrine monotherapy was given to about 10% and chemotherapy to about 15% of all patients. The prognosis was worst in patients treated with chemotherapy. Recently, mainly patients with a good prognosis are being treated with endocrine monotherapy, and patients who are treated with chemotherapy have an unfavorable prognosis. The PFS and OS of patients treated with CDK4/6i + ET have remained similar over time despite changes in patient characteristics. Conclusion A treatment with CDK4/6i + ET has rapidly become the therapy standard for patients in the first-line advanced breast cancer setting. After the implementation of CDK4/6i + ET, endocrine monotherapy is only given to patients with a very favorable prognosis, while chemotherapy is provided to patients with a rather unfavorable prognosis. These changes in patient characteristics did not seem to influence the prognosis of patients treated with CDK4/6i + ET.

引用

页码：1055 / 1067

页数：13

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