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中华乳腺病杂志(电子版) ›› 2024, Vol. 18 ›› Issue (01) : 47 -51. doi: 10.3877/cma.j.issn.1674-0807.2024.01.007

综述

细胞周期蛋白依赖性激酶4/6抑制剂在乳腺癌内分泌治疗中的应用
穆星豆1, 姜月2, 张聚良1,()   
  1. 1. 710032 西安,空军军医大学第一附属医院血管内分泌外科
    2. 721008 宝鸡市中心医院乳腺科
  • 收稿日期:2022-11-15 出版日期:2024-02-01
  • 通信作者: 张聚良

Application of cyclin-dependent kinase 4 / 6 inhibitors in endocrine therapy of breast cancer

Xingdou Mu, Yue Jiang, Juliang Zhang()   

  • Received:2022-11-15 Published:2024-02-01
  • Corresponding author: Juliang Zhang
引用本文:

穆星豆, 姜月, 张聚良. 细胞周期蛋白依赖性激酶4/6抑制剂在乳腺癌内分泌治疗中的应用[J]. 中华乳腺病杂志(电子版), 2024, 18(01): 47-51.

Xingdou Mu, Yue Jiang, Juliang Zhang. Application of cyclin-dependent kinase 4 / 6 inhibitors in endocrine therapy of breast cancer[J]. Chinese Journal of Breast Disease(Electronic Edition), 2024, 18(01): 47-51.

细胞周期蛋白依赖性激酶(CDK)4/6抑制剂是作用于CDK的靶向药物。在激素受体阳性乳腺癌的治疗中,CDK4/6抑制剂联合内分泌治疗显示出良好的疗效。然而,CDK4/6抑制剂的治疗时序、组合策略、应用时机等仍存在争议,临床研究结果也不一致,几种CDK4/6抑制剂是否存在疗效和不良反应的差异等尚不清楚。本文梳理了CDK4/6抑制剂在早期及晚期乳腺癌中的重要临床研究,对临床研究进展和热点问题进行了讨论。

[1]
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: breast cancer[EB/OL]. [2022-12-20].

URL    
[2]
中国女医师协会临床肿瘤学专业委员会,中国抗癌协会乳腺癌专业委员会.中国进展期乳腺癌诊疗共识指南(CABC 2015)[J]. 癌症进展201513(3):223-245.
[3]
Partridge AH, Rumble RB, Carey LA, et al. Chemotherapy and targeted therapy for women with human epidermal growth factor receptor 2-negative(or unknown)advanced breast cancer: American Society of Clinical Oneology Clinical Practice Guideline [J]. Clin Oncol, 201432(29):3307-3329.
[4]
Dixon AR, Jackson L, Chan S, et al. A randomised trial of second-line hormone vs single agent chemotherapy in tamoxifen resistant advanced breast cancer [J]. Br J Cancer, 1992, 66: 402-404.
[5]
Jerusalem G, De Boer RH, Hurvitz S, et al. Everolimus plus exemestane vs everolimus or capecitabine monotherapy for estrogen receptor-positive, HER-2-negative advanced breast cancer [J]. JAMA Oncol, 2018, 4(10): E1-E8.
[6]
Park YH, Kim TY, Kim GM, et al. Palbociclib plus exemestane with gonadotropin-releasing hormone agonist versus capecitabine in premenopausal women with hormone receptor-positive, HER-2-negative metastatic breast cancer (KCSG-BR15-10): a multicentre, open-label, randomised, phase 2 trial [J]. Lancet Oncol, 2019, 20(12): 1750-1759.
[7]
Martin M, Zielinski C, Ruiz-Borrego M, et al. Palbociclib in combination with endocrine therapy versus capecitabine in hormonal receptor-positive, human epidermal growth factor 2-negative, aromatase inhibitor-resistant metastatic breast cancer: a phase III randomized controlled trial-PEARL [J]. Ann Oncol, 2021, 32(4): 488-99.
[8]
Giuliano M, Schettini F, Rognoni C, et al. Endocrine treatment versus chemotherapy in postmenopausal women with hormone receptor-positive, HER-2-negative, metastatic breast cancer: a systematic review and network meta-analysis [J]. Lancet Oncol, 2019, 20(10): 1360-1369.
[9]
Finn RS, Martin M, Rugo HS, et al. Palbociclib and letrozole in advanced breast cancer [J]. N Engl J Med, 2016, 375(20): 1925-1936.
[10]
Goetz MP, Toi M, Campone M, et al. MONARCH 3: abemaciclib as initial therapy for advanced breast cancer [J]. N Engl J Med, 2017, 35(32): 3638-3646.
[11]
Johnston S, Martin M, Di Leo A, et al. MONARCH 3 final PFS: a randomized study of abemaciclib as initial therapy for advanced breast cancer [J]. NPJ Breast Cancer, 2019, 5(5): 1-8.
[12]
Hortobagyi GN, Stemmer SM, Burris HA, et al. Updated results from MONALEESA-2, a phase III trial of first-line ribociclib plus letrozole versus placebo plus letrozole in hormone receptor-positive, HER-2-negative advanced breast cancer [J]. J Clin Oncol, 2017, 35(15): 1038-1038.
[13]
Ellis MJ, Llombart-Cussac A, Feltl D, et al. Fulvestrant 500 mg versus anastrozole 1 mg for the first-line treatment of advanced breast cancer: overall survival analysis from the phase II FIRST study [J]. J Clin Oncol, 2015, 33(32): 3781-3787.
[14]
Robertson JFR, Bondarenko IM, Trishkina E, et al. Fulvestrant 500 mg versus anastrozole 1 mg for hormone receptor-positive advanced breast cancer (FALCON): an international, randomised, double-blind, phase 3 trial [J]. Lancet, 2016, 388(10063): 2997-3005.
[15]
Guo Q, Lin X, YE L, et al. Comparative efficacy of CDK4/6 inhibitors plus aromatase inhibitors versus fulvestrant for the first-line treatment of hormone receptor-positive advanced breast cancer: a network meta-analysis [J]. Target Oncol, 2019, 14(2): 139-148.
[16]
Slamon DJ, Neven P, Chia S, et al. Phase III randomized study of ribociclib and fulvestrant in hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer: MONALEESA-3 [J]. Clin Oncol, 2018, 36(25):2465-2472.
[17]
Slamon DJ, Neven P, Chia S, et al. Overall survival with ribociclib plus fulvestrant in advanced breast cancer [J]. N Engl J Med, 2020, 382(6): 514-524.
[18]
Albanell J, Martinez MT, Ramos M, et al. Randomized phase II study of fulvestrant plus palbociclib or placebo in endocrine-sensitive, hormone receptor-positive/HER2-advanced breast cancer: GEICAM/2014-12 (FLIPPER) [J]. Eur J Cancer, 2022, 161: 26-37.
[19]
Llombart-Cussac A, Pérez-García JM, Bellet M, et al. Fulvestrant-palbociclib vs letrozole-palbociclib as initial therapy for endocrine-sensitive, hormone receptor-positive, ERBB2-negative advanced breast cancer: a randomized clinical trial [J]. JAMA Oncol, 20217(12):1791-1799.
[20]
Fasching PA, Delea T, LU YS, et al. 330P comparative effectiveness of ribociclib plus fulvestrant (RIB+FUL) versus palbociclib plus letrozole (PAL+LET) as first-line (1L) treatment (Tx) of HR+/HER-2- advanced breast cancer (ABC) assessed by matching-adjusted indirect comparison (MAIC) [J]. Ann Oncol, 2020, 31: S377-S378.
[21]
Chandarlapaty S, Chen D, HE W, et al. Prevalence of ESR1 mutations in cell-free DNA and outcomes in metastatic breast cancer: a secondary analysis of the BOLERO-2 clinical trial [J]. JAMA Oncol, 2016, 2(10): 1310-1315.
[22]
Berger F, Marce M, Delaloge S, et al. Randomised, open-label, multicentric phase III trial to evaluate the safety and efficacy of palbociclib in combination with endocrine therapy, guided by ESR1 mutation monitoring in oestrogen receptor-positive, HER2-negative metastatic breast cancer patients: study design of PADA-1[J]. BMJ Open, 202212: e055821.
[23]
Bidard FC, Hardy-Bessard AC, Dalenc F, et al. Switch to fulvestrant and palbociclib versus no switch in advanced breast cancer with rising ESR1 mutation during aromatase inhibitor and palbociclib therapy (PADA-1): a randomised, open-label, multicentre, phase 3 trial [J]. Lancet Oncol, 2022, 23(11)1367-1377.
[24]
André F, Ciruelos E, Rubovszky G, et al. Alpelisib for PIK3CA-mutated, hormone receptor-positive advanced breast cancer [J]. N Engl J Med, 2019, 380(20): 1929-1940.
[25]
Rugo HS, Lerebours F, Ciruelos E, et al. Alpelisib plus fulvestrant in PIK3CA-mutated, hormone receptor-positive advanced breast cancer after a CDK4/6 inhibitor (BYLieve): one cohort of a phase 2, multicentre, open-label, non-comparative study [J]. Lancet Oncol, 2021, 22(4): 489-498.
[26]
Spring LM, Gupta A, Reynolds KL, et al. Neoadjuvant endocrine therapy for estrogen receptor-positive breast cancer: a systematic review and meta-analysis [J]. JAMA Oncol, 2016, 2(11): 1477-1486.
[27]
Eiermann W, Paepke S, Appfelstaedt J, et al. Preoperative treatment of postmenopausal breast cancer patients with letrozole: a randomized double-blind multicenter study [J]. Ann Oncol, 2001, 12(11): 1527-1532.
[28]
Sheri A, Smith IE, Johnston SR, et al. Residual proliferative cancer burden to predict long-term outcome following neoadjuvant chemotherapy [J]. Ann Oncol, 2015, 26(1): 75-80.
[29]
Ellis MJ, Suman VJ, Hoog J, et al. Randomized phase II neoadjuvant comparison between letrozole, anastrozole, and exemestane for postmenopausal women with estrogen receptor-rich stage 2 to 3 breast cancer: clinical and biomarker outcomes and predictive value of the baseline pam50-based intrinsic subtype-ACOSOG Z1031 [J]. J Clin Oncol, 2011, 29(17): 2342-2349.
[30]
Khan QJ, O’Dea A, Bardia A, et al. Letrozole + ribociclib versus letrozole + placebo as neoadjuvant therapy for ER+ breast cancer (FELINE trial) [J]. Clin Oncol, 2020, 38(15): 505.
[31]
Prat A, Saura C, Pascual T, et al. Ribociclib plus letrozole versus chemotherapy for postmenopausal women with hormone receptor-positive, HER-2-negative, luminal B breast cancer (CORALLEEN): an open-label, multicentre, randomised, phase 2 trial [J]. Lancet Oncol, 2020, 21(1): 33-43.
[32]
Cottu P, D’Hondt V, Dureau S, et al. Letrozole and palbociclib versus chemotherapy as neoadjuvant therapy of high-risk luminal breast cancer [J]. Ann Oncol, 2018, 29(12): 2334-2340.
[33]
Delaloge S, Dureau S, D’Hondt V, et al. Survival outcomes after neoadjuvant letrozole and palbociclib versus third generation chemotherapy for patients with high-risk oestrogen receptor-positive HER2-negative breast cancer [J]. Eur J Cancer, 2022, 166:300-308.
[34]
O’Shaughnessy J, Johnston SRD, Harbeck N, et al. Primary outcome analysis of invasive disease-free survival for monarch E: abemaciclib combined with adjuvant endocrine therapy for high-risk early breast cancer[EB/OL]. [2023-05-10].

URL    
[35]
Johnston SRD, Harbeck N, Hegg R, et al. Abemaciclib combined with endocrine therapy for the adjuvant treatment of HR+,HER2-,node-positive, high risk, early breast cancer (monarch E) [J]. Ann Oncol, 2020, 31(4): S1143.
[36]
Johnston SRD, Toi M, O’Shaughnessy J, et al. Abemaciclib plus endocrine therapy for hormone receptor-positive, HER2-negative, node-positive, high-risk early breast cancer (monarch E): results from a preplanned interim analysis of a randomised, open-label, phase 3 trial [J]. Lancet Oncol, 2023, 24(1): 77-90.
[37]
Mayer EL, Demichele AM, Pfeiler G, et al. PALLAS: a randomized phase III trial of adjuvant palbociclib with endocrine therapy versus endocrine therapy alone for HR+/HER2- early breast cancer [J]. Ann Oncol, 2020, 31:S1145.
[38]
Loibl S, Marmé F, Martin M, et al. Palbociclib for residual high-risk invasive HR-positive and HER-2-negative early breast cancer-the Penelope-B trial [J]. Clin Oncol, 2021, 39(14): 1518-1530.
[39]
Dickler MN, Tolaney SM, Rugo HS, et al. MONARCH 1, a phase II study of abemaciclib, a CDK4 and CDK6 inhibitor, as a single agent, in patients with refractory HR(+)/HER-2(-) metastatic breast cancer [J]. Clin Cancer Res, 2017, 23(17): 5218-5224.
[40]
Spring LM, Zangardi ML, Moy B, et al. Clinical management of potential toxicities and drug interactions related to cyclin-dependent kinase 4/6 inhibitors in breast cancer: practical considerations and recommendations [J]. Oncologist, 2017, 22(9): 1039-1048.
[41]
Desnoyers A, Nadler MB, Kumar V, et al. Comparison of treatment-related adverse events of different cyclin-dependent kinase 4/6 inhibitors in metastatic breast cancer: a network meta-analysis [J]. Cancer Treat Rev, 2020, 90(1):102 086.
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