Locoregional Radiotherapy in Patients with Advanced Breast Cancer Treated with Cyclin-Dependent Kinase 4/6 Inhibitors Based on Real-World Data

Pharmaceuticals Pub Date : 2024-07-11 DOI:10.3390/ph17070927

M. Kubeczko, Dorota Gabryś, A. Polakiewicz-Gilowska, Barbara Bobek-Billewicz, Michał Jarząb

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Abstract

Background. The use of locoregional radiotherapy (RT) in patients with advanced ER-positive, HER2-negative breast cancer remains a topic of ongoing debate. In this study, we aimed to evaluate the efficacy of locoregional RT in advanced breast cancer patients treated with cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) in a first-line setting. Methods. We conducted a retrospective analysis of patients diagnosed with advanced breast cancer between 2018 and 2023 who received treatment with CDK4/6i and underwent locoregional radiotherapy. Results. Among the 371 patients treated with CDK4/6i as part of their first-line therapy, 23 received locoregional RT either concurrently or sequentially with CDK4/6 inhibitors. Disease progression within the breast occurred in 19 patients (5.1%). Among these cases, five patients had previously undergone breast RT (5/23, 21.7%), while 14 did not (14/348, 4.0%, p = 0.004). All cases of local progression after RT followed palliative doses and were accompanied by early systemic progression. The 2-year PFS in the entire cohort of patients treated with locoregional RT was 65.7% (95% CI: 40.5–82.3%). Notably, patients who received higher RT doses had longer 2-year PFS (83.3%, 95% CI: 27.3–97.5%) than those with palliative RT doses (59.3%, 95% CI: 30.7–79.3%); however, the results were not statistically significant (p = 0.58). Furthermore, the 2-year local control in the entire cohort with locoregional RT was 73.0% (95% CI: 46.5–87.9%). Importantly, no local progression was observed after RT when using high doses. Conclusions. The addition of locoregional radiotherapy to first-line CDK4/6 inhibitors warrants further investigation across various clinical scenarios in advanced breast cancer. Palliative radiation regimens delivered early in breast oligoprogression may not always suffice, emphasizing the need for comprehensive studies in this context.

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基于真实世界数据的细胞周期蛋白依赖性激酶 4/6 抑制剂治疗晚期乳腺癌患者的局部放射治疗

背景。在ER阳性、HER2阴性的晚期乳腺癌患者中使用局部放疗（RT）仍是一个争论不休的话题。在本研究中，我们旨在评估一线使用细胞周期蛋白依赖性激酶 4/6 抑制剂（CDK4/6i）治疗的晚期乳腺癌患者局部 RT 的疗效。方法我们对2018年至2023年间确诊的晚期乳腺癌患者进行了回顾性分析，这些患者接受了CDK4/6i治疗并进行了局部放疗。结果。在371名接受CDK4/6i作为一线治疗的患者中，有23名患者在接受CDK4/6抑制剂治疗的同时或先后接受了局部RT治疗。19名患者（5.1%）出现乳腺疾病进展。在这些病例中，有5名患者之前接受过乳腺RT治疗（5/23，21.7%），14名患者没有接受过乳腺RT治疗（14/348，4.0%，P = 0.004）。所有RT后局部进展的病例均为姑息性剂量，并伴有早期全身性进展。接受局部 RT 治疗的所有患者的 2 年生存率为 65.7%（95% CI：40.5-82.3%）。值得注意的是，与接受姑息性 RT 剂量的患者（59.3%，95% CI：30.7-79.3%）相比，接受较高 RT 剂量的患者的 2 年 PFS 更长（83.3%，95% CI：27.3-97.5%）；但结果并无统计学意义（P = 0.58）。此外，整个队列中使用局部区域 RT 的 2 年局部控制率为 73.0%（95% CI：46.5-87.9%）。重要的是，使用高剂量 RT 后未观察到局部进展。结论在一线CDK4/6抑制剂的基础上增加局部放疗，值得在晚期乳腺癌的各种临床情况下进一步研究。在乳腺癌寡核苷酸进展早期进行姑息性放射治疗可能并不总是足够的，这就强调了在这种情况下进行全面研究的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Pharmaceuticals

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