Activity of CDK4/6 inhibitors and parameters affecting survival in elderly patients in age-subgroups: Turkish Oncology Group (TOG) retrospective study

Highly selective inhibitors of cyclin-dependent kinase 4 and 6 (CDK4/6is) have emerged as a standart of care for first- and second-line therapies in combination with endocrine therapy (ET) for HR+/HER2- metastatic breast cancer (MBC) patients. It has been reported that combination therapy is more effective than ET alone and is safe in elderly patients as well as young patients. Nevertheless, elderly and very old patients with HR+/HER2-MBC treated with CDK4/6 inhibitor (CDK4/6i) combinations are relatively underrepresented in randomized controlled trials. To contribute to the literature, we investigated the real-world efficacy, factors associated with survival and the rates of adverse events (AEs) of the treatment with palbociclib or ribociclib plus ET in the HR+/HER2- MBC patient cohort over the age of 65 for age subgroups. In this retrospective study, 348 patients were divided into subgroups: 65-69 years old, 70-79 years old and 80 years and older. Median PFS (mPFS) for whole group was 18.3 (95% CI,14.3-22.3) months. There was no significant difference in mPFS between age groups (p = 0.75). The estimated median OS (mOS) was 39.5 (95% CI, 24.9-54.1) months and there was no significant difference between age groups (p = 0.15). There was a meaningfull numerical difference that did not reach statistical significance in patients who received CDK4/6i treatment as the first line for MBC. Grade 3-4 AEs were reported in 42.7% for the entire group, and neutropenia was the most common (37.3%). It can be concluded that combination therapy with palbociclib or ribociclib with an ET partner has similar efficacy and is safe among subgroups of older patients diagnosed with HR+/HER2-MBC.

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Publication Details

Journal
BMC Cancer
Published
2024-12-30
DOI
https://doi.org/10.1186/s12885-024-13357-5
Citations
4
Primary Topic
Advanced Breast Cancer Therapies
Type
article
Field-Weighted Citation Impact
1.68
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article

Activity of CDK4/6 inhibitors and parameters affecting survival in elderly patients in age-subgroups: Turkish Oncology Group (TOG) retrospective study

Merve Keskinkılıç, Sena Ece Davarcı, Burçin Çakan Demirel, Deniz Işık et al.
4 citations
BMC Cancer
Advanced Breast Cancer Therapies
1.68
article

Activity of CDK4/6 inhibitors and parameters affecting survival in elderly patients in age-subgroups: Turkish Oncology Group (TOG) retrospective study

Merve Keskinkılıç, Sena Ece Davarcı, Burçin Çakan Demirel, Deniz Işık, Eda Eylemer Mocan, Seda Kahraman, Dinçer Aydın, Funda Yılmaz, Nurhan Önal Kalkan, Özge Gümüşay, Ömer Acar, Sadi Kerem Okutur, Yusuf Karakaş, Burcu Gülbağcı, Teoman Şakalar, Mehmet Alı Nahıt Şendur, Musa Barış Aykan, Mutlu Hızal, Asude Aksoy, Nazım Serdar Turhal, Ertuğrul Bayram, Ali̇ İnal, Berna Bozkurt Duman, Veli Sunar, Melike Özçelik, Esra Aydın, Muhammed Muhiddin Er, Başak Oyan Uluç, Serkan Menekşe, Gülhan Özkanlı, Alper Yaşar, Hakan Yucel, Özlem Doğan, Özlem Özdemir, Deniz Can Güven, Murat Keser, Önder Eren, Müge Karaoğlanoğlu
article en
4 citations

Abstract

Highly selective inhibitors of cyclin-dependent kinase 4 and 6 (CDK4/6is) have emerged as a standart of care for first- and second-line therapies in combination with endocrine therapy (ET) for HR+/HER2- metastatic breast cancer (MBC) patients. It has been reported that combination therapy is more effective than ET alone and is safe in elderly patients as well as young patients. Nevertheless, elderly and very old patients with HR+/HER2-MBC treated with CDK4/6 inhibitor (CDK4/6i) combinations are relatively underrepresented in randomized controlled trials. To contribute to the literature, we investigated the real-world efficacy, factors associated with survival and the rates of adverse events (AEs) of the treatment with palbociclib or ribociclib plus ET in the HR+/HER2- MBC patient cohort over the age of 65 for age subgroups. In this retrospective study, 348 patients were divided into subgroups: 65-69 years old, 70-79 years old and 80 years and older. Median PFS (mPFS) for whole group was 18.3 (95% CI,14.3-22.3) months. There was no significant difference in mPFS between age groups (p = 0.75). The estimated median OS (mOS) was 39.5 (95% CI, 24.9-54.1) months and there was no significant difference between age groups (p = 0.15). There was a meaningfull numerical difference that did not reach statistical significance in patients who received CDK4/6i treatment as the first line for MBC. Grade 3-4 AEs were reported in 42.7% for the entire group, and neutropenia was the most common (37.3%). It can be concluded that combination therapy with palbociclib or ribociclib with an ET partner has similar efficacy and is safe among subgroups of older patients diagnosed with HR+/HER2-MBC.

BMC CancerVol. 24(1)
Sakarya University (TR), Çanakkale Onsekiz Mart Üniversitesi (TR), Van Yüzüncü Yıl Üniversitesi (TR), Anadolu University (TR), Selçuk University (TR), Ankara University (TR), Recep Tayyip Erdoğan University (TR), Manisa Celal Bayar University (TR), Istanbul Aydın University (TR), Dokuz Eylül University (TR), Acıbadem University (TR), Memorial Ankara Hospital (TR), Necmettin Erbakan University (TR), Ankara Onkoloji Eğitim ve Araştırma Hastanesi (TR), Ümraniye Eğitim ve Araştırma Hastanesi (TR), Hacettepe University Hospital (TR), Izmir Bozyaka Eğitim ve Araştırma Hastanesi (TR), Elazığ Eğitim ve Araştırma Hastanesi (TR), Ankara Yıldırım Beyazıt University (TR), Acıbadem Adana Hospital (TR), Afyonkarahisar Sağlık Bilimleri Üniversitesi, Kahramanmaraş Sütçü İmam University (TR), Pamukkale University (TR), Istanbul Arel University (TR), Mersin Üniversitesi (TR), Kocaeli Üniversitesi (TR), Afyon Kocatepe University (TR), Cukurova University (TR), Gaziantep University (TR), Ordu University (TR), Marmara University (TR)
Openalex Percentile: Top 14%
Advanced Breast Cancer Therapies
1.68
DOIOpen Access PDFOpenAlex
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