Hormone receptor positive, HER2 negative metastatic breast cancer: Impact of CDK4/6 inhibitors on the current treatment paradigm

Frances Boyle; Jane Beith; Katie Burslem; Richard de Boer; Rina Hui; Elgene Lim; Nicole McCarthy; Andrew Redfern; Natasha Woodward

doi:10.1111/ajco.13064

Hormone receptor positive, HER2 negative metastatic breast cancer: Impact of CDK4/6 inhibitors on the current treatment paradigm

Asia Pac J Clin Oncol. 2018 Oct:14 Suppl 4:3-11. doi: 10.1111/ajco.13064.

Authors

Frances Boyle^{1

2}, Jane Beith^{2

3}, Katie Burslem⁴, Richard de Boer⁵, Rina Hui^{2

6}, Elgene Lim^{7

8}, Nicole McCarthy^{9

10}, Andrew Redfern¹¹, Natasha Woodward^{10

12}

Affiliations

¹ Mater Hospital, North Sydney, NSW, 2060, Australia.
² University of Sydney, Sydney, NSW, 2006, Australia.
³ Chris O'Brien Lifehouse, Camperdown, NSW, 2050, Australia.
⁴ WriteSource Medical Pty Ltd, Lane Cove, NSW, 1595, Australia.
⁵ Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia.
⁶ Westmead Hospital, Westmead, NSW, 2145, Australia.
⁷ St.Vincent's Clinical School, University of New South Wales, Darlinghurst, NSW, 2010, Australia.
⁸ Garvan Institute of Medical Research, Darlinghurst, NSW, 2010, Australia.
⁹ ICON Cancer Care Wesley, Auchenflower, QLD, 4066, Australia.
¹⁰ University of Queensland, St Lucia, QLD, 4072, Australia.
¹¹ Fiona Stanley Hospital, Perth, WA, 6150, Australia.
¹² Mater Misericordiae Ltd and Mater Research Institute Raymond Terrace, South Brisbane, QLD, 4101, Australia.

PMID: 30288930
DOI: 10.1111/ajco.13064

Abstract

Resistance to endocrine therapy is a significant therapeutic challenge in the treatment of women with hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) advanced breast cancer. Cyclin-dependent kinase (CDK)4/6 inhibitors in combination with endocrine therapy have been shown to improve progression free survival, overall response rate and clinical benefit rate in women with HR+ HER2- metastatic breast cancer compared with endocrine therapy alone. This review examines the clinical evidence to support the use of CDK4/6 inhibitors in first and second line settings. Practical guidance is provided for the use of CDK4/6 inhibitors, including tolerability data, monitoring requirements and management of key toxicities for each of the available agents.

Keywords: CDK4/6 inhibitor; endocrine therapy; metastatic breast cancer.

MeSH terms

Breast Neoplasms / genetics*
Breast Neoplasms / pathology
Cyclin-Dependent Kinase 4 / antagonists & inhibitors*
Cyclin-Dependent Kinase 4 / pharmacology
Cyclin-Dependent Kinase 4 / therapeutic use*
Female
Humans
Receptor, ErbB-2 / metabolism*

Substances

Receptor, ErbB-2
CDK4 protein, human
Cyclin-Dependent Kinase 4

Grants and funding

Novartis Pharmaceuticals Australia