BMC Cancer (Feb 2023)
Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy
- Cengiz Karacin,
- Berna Oksuzoglu,
- Ayşe Demirci,
- Merve Keskinkılıç,
- Naziyet Köse Baytemür,
- Funda Yılmaz,
- Oğuzhan Selvi,
- Dilek Erdem,
- Esin Avşar,
- Nail Paksoy,
- Necla Demir,
- Sema Sezgin Göksu,
- Sema Türker,
- Ertuğrul Bayram,
- Abdüssamet Çelebi,
- Hatice Yılmaz,
- Ömer Faruk Kuzu,
- Seda Kahraman,
- İvo Gökmen,
- Abdullah Sakin,
- Ali Alkan,
- Erdinç Nayır,
- Muzaffer Uğraklı,
- Ömer Acar,
- İsmail Ertürk,
- Hacer Demir,
- Ferit Aslan,
- Özlem Sönmez,
- Taner Korkmaz,
- Özde Melisa Celayir,
- İbrahim Karadağ,
- Erkan Kayıkçıoğlu,
- Teoman Şakalar,
- İlker Nihat Öktem,
- Tülay Eren,
- Enes Erul,
- Eda Eylemer Mocan,
- Ziya Kalkan,
- Nilgün Yıldırım,
- Yakup Ergün,
- Baran Akagündüz,
- Serdar Karakaya,
- Engin Kut,
- Fatih Teker,
- Burçin Çakan Demirel,
- Kubilay Karaboyun,
- Elvina Almuradova,
- Olçun Ümit Ünal,
- Abdilkerim Oyman,
- Deniz Işık,
- Kerem Okutur,
- Buğra Öztosun,
- Burcu Belen Gülbağcı,
- Mehmet Emin Kalender,
- Elif Şahin,
- Mustafa Seyyar,
- Özlem Özdemir,
- Fatih Selçukbiricik,
- Metin Kanıtez,
- İsa Dede,
- Mahmut Gümüş,
- Erhan Gökmen,
- Arzu Yaren,
- Serkan Menekşe,
- Senar Ebinç,
- Sercan Aksoy,
- Gökşen İnanç İmamoğlu,
- Mustafa Altınbaş,
- Bülent Çetin,
- Başak Oyan Uluç,
- Özlem Er,
- Nuri Karadurmuş,
- Atike Pınar Erdoğan,
- Mehmet Artaç,
- Özgür Tanrıverdi,
- İrfan Çiçin,
- Mehmet Ali Nahit Şendur,
- Esin Oktay,
- İbrahim Vedat Bayoğlu,
- Semra Paydaş,
- Adnan Aydıner,
- Derya Kıvrak Salim,
- Çağlayan Geredeli,
- Tuğba Yavuzşen,
- Mutlu Doğan,
- İlhan Hacıbekiroğlu
Affiliations
- Cengiz Karacin
- Department of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital
- Berna Oksuzoglu
- Department of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital
- Ayşe Demirci
- Department of Medical Oncology, Sakarya University
- Merve Keskinkılıç
- Department of Medical Oncology, Dokuz Eylül University
- Naziyet Köse Baytemür
- Department of Medical Oncology, Memorial Hospital
- Funda Yılmaz
- Department of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital
- Oğuzhan Selvi
- Department of Medical Oncology, Okmeydanı Prof. Dr. Cemil Taşcıoğlu City Hospital
- Dilek Erdem
- Department of Medical Oncology, VM Medical Park Hospital
- Esin Avşar
- Department of Medical Oncology, Antalya Training and Research Hospital
- Nail Paksoy
- Department of Medical Oncology, Istanbul University Instıtue of Oncology
- Necla Demir
- Department of Medical Oncology, Acıbadem Hospital
- Sema Sezgin Göksu
- Department of Medical Oncology, Akdeniz University
- Sema Türker
- Department of Medical Oncology, Zonguldak Hospital
- Ertuğrul Bayram
- Department of Medical Oncology, Çukurova University
- Abdüssamet Çelebi
- Department of Medical Oncology, Marmara University Pendik Training and Research Hospital
- Hatice Yılmaz
- Department of Medical Oncology, Adnan Menderes University
- Ömer Faruk Kuzu
- Department of Medical Oncology, Ankara City Hospital
- Seda Kahraman
- Department of Medical Oncology, Ankara City Hospital
- İvo Gökmen
- Department of Medical Oncology, Trakya University
- Abdullah Sakin
- Department of Medical Oncology, Istanbul Medipol University Bahçelievler Hospital
- Ali Alkan
- Department of Medical Oncology, Muğla Sıtkı Koçman University
- Erdinç Nayır
- Mersin Medical Park Hospital, Department of Medical Oncology
- Muzaffer Uğraklı
- Department of Medical Oncology, Necmettin Erbakan University
- Ömer Acar
- Department of Medical Oncology, Celal Bayar University
- İsmail Ertürk
- Department of Medical Oncology, Gülhane Training and Research Hospital
- Hacer Demir
- Department of Medical Oncology, Afyonkarahisar Health Sciences University Hospital
- Ferit Aslan
- Department of Medical Oncology, Ankara Medical Park Hospital
- Özlem Sönmez
- Department of Medical Oncology, Acıbadem University Maslak Hospital
- Taner Korkmaz
- Department of Medical Oncology, Acıbadem University Maslak Hospital
- Özde Melisa Celayir
- Department of Medical Oncology, Acıbadem University Maslak Hospital
- İbrahim Karadağ
- Department of Medical Oncology, Hitit University Hospital
- Erkan Kayıkçıoğlu
- Department of Medical Oncology, Süleyman Demirel University Hospital
- Teoman Şakalar
- Department of Medical Oncology, Kahramanmaraş Necip Fazıl City Hospital
- İlker Nihat Öktem
- Department of Medical Oncology, Ersin Arslan Training and Research Hospital
- Tülay Eren
- Department of Medical Oncology, UHS Dışkapı Yıldırım Beyazıt Training and Research Hospital
- Enes Erul
- Department of Medical Oncology, Hacettepe University Instıtue of Oncology
- Eda Eylemer Mocan
- Department of Medical Oncology, Ankara University
- Ziya Kalkan
- Department of Medical Oncology, Dicle University
- Nilgün Yıldırım
- Department of Medical Oncology, Fırat University
- Yakup Ergün
- Batman Training and Research Hospital
- Baran Akagündüz
- Department of Medical Oncology, Erzincan Binali Yıldırım University
- Serdar Karakaya
- Department of Medical Oncology, Atatürk Pulmonary Diseases Hospital
- Engin Kut
- Department of Medical Oncology, Manisa City Hospital
- Fatih Teker
- Department of Medical Oncology, Gaziantep University
- Burçin Çakan Demirel
- Department of Medical Oncology, Pamukkale University
- Kubilay Karaboyun
- Department of Medical Oncology, Namık Kemal University
- Elvina Almuradova
- Department of Medical Oncology, Ege University
- Olçun Ümit Ünal
- UHS İzmir Tepecik Training and Research Hospital
- Abdilkerim Oyman
- Department of Medical Oncology, Ümraniye Training and Research Hospital
- Deniz Işık
- Kocaeli Medical Park, Department of Medical Oncology
- Kerem Okutur
- Department of Medical Oncology, Bahçelievler Memorial Hospital
- Buğra Öztosun
- Department of Medical Oncology, Istanbul Medeniyet University
- Burcu Belen Gülbağcı
- Department of Medical Oncology, Sakarya University
- Mehmet Emin Kalender
- Department of Medical Oncology, Meddem Hospital
- Elif Şahin
- Department of Medical Oncology, Kocaeli University
- Mustafa Seyyar
- Department of Medical Oncology, Kocaeli University
- Özlem Özdemir
- İzmir Bozyaka Training and Research Hospital
- Fatih Selçukbiricik
- Department of Medical Oncology, Koç University
- Metin Kanıtez
- Department of Medical Oncology, American Hospital
- İsa Dede
- Department of Medical Oncology, Mustafa Kemal University
- Mahmut Gümüş
- Department of Medical Oncology, Istanbul Medeniyet University
- Erhan Gökmen
- Department of Medical Oncology, Ege University
- Arzu Yaren
- Department of Medical Oncology, Pamukkale University
- Serkan Menekşe
- Department of Medical Oncology, Manisa City Hospital
- Senar Ebinç
- Department of Medical Oncology, Dicle University
- Sercan Aksoy
- Department of Medical Oncology, Hacettepe University Instıtue of Oncology
- Gökşen İnanç İmamoğlu
- Department of Medical Oncology, UHS Dışkapı Yıldırım Beyazıt Training and Research Hospital
- Mustafa Altınbaş
- Department of Medical Oncology, UHS Dışkapı Yıldırım Beyazıt Training and Research Hospital
- Bülent Çetin
- Department of Medical Oncology, Süleyman Demirel University Hospital
- Başak Oyan Uluç
- Department of Medical Oncology, Acıbadem University Maslak Hospital
- Özlem Er
- Department of Medical Oncology, Acıbadem University Maslak Hospital
- Nuri Karadurmuş
- Department of Medical Oncology, Gülhane Training and Research Hospital
- Atike Pınar Erdoğan
- Department of Medical Oncology, Celal Bayar University
- Mehmet Artaç
- Department of Medical Oncology, Necmettin Erbakan University
- Özgür Tanrıverdi
- Department of Medical Oncology, Muğla Sıtkı Koçman University
- İrfan Çiçin
- Department of Medical Oncology, Trakya University
- Mehmet Ali Nahit Şendur
- Department of Medical Oncology, Ankara City Hospital
- Esin Oktay
- Department of Medical Oncology, Adnan Menderes University
- İbrahim Vedat Bayoğlu
- Department of Medical Oncology, Marmara University Pendik Training and Research Hospital
- Semra Paydaş
- Department of Medical Oncology, Çukurova University
- Adnan Aydıner
- Department of Medical Oncology, Istanbul University Instıtue of Oncology
- Derya Kıvrak Salim
- Department of Medical Oncology, Antalya Training and Research Hospital
- Çağlayan Geredeli
- Department of Medical Oncology, Okmeydanı Prof. Dr. Cemil Taşcıoğlu City Hospital
- Tuğba Yavuzşen
- Department of Medical Oncology, Dokuz Eylül University
- Mutlu Doğan
- Department of Medical Oncology, UHS Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital
- İlhan Hacıbekiroğlu
- Department of Medical Oncology, Sakarya University
- DOI
- https://doi.org/10.1186/s12885-023-10609-8
- Journal volume & issue
-
Vol. 23,
no. 1
pp. 1 – 10
Abstract
Abstract Background There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based). Methods A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and ≥ 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy. Results The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0–14.0) months in the ET arm of group A, and 5.3 (3.9–6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8–7.7) months in the ET arm of group B, and 5.7 (4.6–6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5–8.0) months in the ET arm of group C and 4.0 (3.5–4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months. Conclusion Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET.
Keywords