Use of Metronomic Chemotherapy in Hormone Receptor-Positive/HER2-Negative Metastatic Breast Cancer: A Retrospective Multicenter Study.

IF 3.5 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2026-10-01 DOI:10.1002/cam4.72325

Lara Laini, Deborah Cosentini, Marta Laganà, Salvatore Grisanti, Giulia Scartabellati, Gianluca Fogazzi, Salvatore Strazzeri, Vito Amoroso, Greta Schivardi, Rebecca Pedersini, Alfredo Berruti, Antonella Turla

{"title":"Use of Metronomic Chemotherapy in Hormone Receptor-Positive/HER2-Negative Metastatic Breast Cancer: A Retrospective Multicenter Study.","authors":"Lara Laini, Deborah Cosentini, Marta Laganà, Salvatore Grisanti, Giulia Scartabellati, Gianluca Fogazzi, Salvatore Strazzeri, Vito Amoroso, Greta Schivardi, Rebecca Pedersini, Alfredo Berruti, Antonella Turla","doi":"10.1002/cam4.72325","DOIUrl":null,"url":null,"abstract":"Purpose: The optimal chemotherapy strategy after progression on cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) in hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) metastatic breast cancer remains a matter of controversy. This study evaluated the efficacy of metronomic chemotherapy compared with other post-CDK4/6i treatment strategies in a real-world setting.Patients and methods: This retrospective multicenter study included patients with HR+/HER2- metastatic breast cancer progressing on CDK4/6i plus endocrine therapy and subsequently treated with systemic therapy. Progression-free survival (PFS) was the primary endpoint. Secondary endpoints included overall survival (OS), objective response rate (ORR), clinical benefit rate (CBR), and safety. Propensity score matching (1:2) was performed to reduce selection bias.Results: A total of 177 patients were included, of whom 52 (29.4%) received metronomic chemotherapy. Among treatment strategies, metronomic chemotherapy achieved the longest median PFS (9 months; 95% CI: 5.46-12.53; p = 0.003). In multivariable analysis, metronomic chemotherapy was independently associated with prolonged PFS (HR 0.46, 95% CI: 0.30-0.69; p < 0.001). Median OS did not significantly differ across treatment groups. ORR was 48.0%, and CBR was 60.0% with metronomic chemotherapy. After propensity score matching, metronomic chemotherapy maintained a significant association with improved PFS (HR 0.49, 95% CI: 0.31-0.78; p = 0.003). Toxicities were predominantly Grade 1-2, with no severe adverse events reported in the metronomic cohort.Conclusion: In this real-world study, metronomic chemotherapy was associated with improved disease control and a favorable safety profile in patients with HR+/HER2- metastatic breast cancer progressing after CDK4/6i-based therapy.Trial registration: Protocol Number 0037558/23.","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 10","pages":"e72325"},"PeriodicalIF":3.5000,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624525/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/cam4.72325","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: The optimal chemotherapy strategy after progression on cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) in hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) metastatic breast cancer remains a matter of controversy. This study evaluated the efficacy of metronomic chemotherapy compared with other post-CDK4/6i treatment strategies in a real-world setting.

Patients and methods: This retrospective multicenter study included patients with HR+/HER2- metastatic breast cancer progressing on CDK4/6i plus endocrine therapy and subsequently treated with systemic therapy. Progression-free survival (PFS) was the primary endpoint. Secondary endpoints included overall survival (OS), objective response rate (ORR), clinical benefit rate (CBR), and safety. Propensity score matching (1:2) was performed to reduce selection bias.

Results: A total of 177 patients were included, of whom 52 (29.4%) received metronomic chemotherapy. Among treatment strategies, metronomic chemotherapy achieved the longest median PFS (9 months; 95% CI: 5.46-12.53; p = 0.003). In multivariable analysis, metronomic chemotherapy was independently associated with prolonged PFS (HR 0.46, 95% CI: 0.30-0.69; p < 0.001). Median OS did not significantly differ across treatment groups. ORR was 48.0%, and CBR was 60.0% with metronomic chemotherapy. After propensity score matching, metronomic chemotherapy maintained a significant association with improved PFS (HR 0.49, 95% CI: 0.31-0.78; p = 0.003). Toxicities were predominantly Grade 1-2, with no severe adverse events reported in the metronomic cohort.

Conclusion: In this real-world study, metronomic chemotherapy was associated with improved disease control and a favorable safety profile in patients with HR+/HER2- metastatic breast cancer progressing after CDK4/6i-based therapy.

Trial registration: Protocol Number 0037558/23.

查看原文本刊更多论文

激素受体阳性/ her2阴性转移性乳腺癌节律化疗的应用：一项多中心回顾性研究

目的：细胞周期蛋白依赖性激酶4/6抑制剂（CDK4/6i）治疗激素受体阳性/人表皮生长因子受体2阴性（HR+/HER2-）转移性乳腺癌进展后的最佳化疗策略仍然存在争议。本研究在现实环境中评估了节律化疗与其他cdk4 /6i后治疗策略的疗效。患者和方法：这项回顾性多中心研究纳入了HR+/HER2-转移性乳腺癌患者，这些患者接受CDK4/6i +内分泌治疗，随后接受全身治疗。无进展生存期（PFS）是主要终点。次要终点包括总生存期（OS）、客观缓解率（ORR）、临床获益率（CBR）和安全性。采用倾向得分匹配（1:2）来减少选择偏差。结果：共纳入177例患者，其中52例（29.4%）接受节拍化疗。在治疗策略中，节律化疗获得最长的中位PFS（9个月；95% CI: 5.46-12.53; p = 0.003）。在多变量分析中，节律化疗与延长PFS独立相关（HR 0.46, 95% CI: 0.30-0.69; p）。结论：在这项真实世界的研究中，在基于cdk4 /6i的治疗后，HR+/HER2-转移性乳腺癌进展的患者中，节律化疗与改善疾病控制和良好的安全性相关。试验注册：协议号0037558/23。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.