Introduction: Cyclin-dependent 4/6 kinase (CDK4/6) inhibitors given with endocrine therapy until disease progression are standard of care in the treatment of women with advanced HR-positive Her-2-negative breast cancer. No data are available if therapy can be safely de-escalated to endocrine monotherapy in patients with long-lasting disease control. Methods: We performed a retrospective analysis on the clinical course of 22 patients at our center who received CDK4/6 inhibitors with aromatase inhibitors or fulvestrant. All patients had at least stable disease for #x3e;6 months and made a joint decision with their provider to electively discontinue CDK4/6 inhibitors. Best objective response (BOR) at treatment discontinuation, progression-free survival, and re-treatment characteristics were recorded. Results: Of 138 patients who received CDK4/6 inhibitors as first- or second-line therapy at our center, 22 met the inclusion criteria. Median duration of CDK4/6 treatment was 18 months (range 6–45). BOR was complete response in 1, partial response in 8, and stable disease in 13 patients. After a median duration of endocrine monotherapy of 9.5 months (range 5–44 months), 6 of 22 patients had progressive disease (1 local relapse and 5 systemic progression). All patients with disease progression had at least stable disease to chemotherapy (N = 1) or re-treatment with CDK4/6 inhibitors (N = 4). Conclusion: Elective discontinuation of CDK4/6 inhibitors is feasible in patients with long-lasting disease stabilization. This strategy should be evaluated in prospective trials.
Oncol Res Treat

中文翻译：

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转移性激素受体阳性、Her-2 阴性乳腺癌患者选择性停用 CDK4/6 抑制剂：回顾性单中心经验

介绍：细胞周期蛋白依赖性 4/6 激酶 (CDK4/6) 抑制剂与内分泌治疗一起使用直至疾病进展是晚期 HR 阳性 Her-2 阴性乳腺癌女性的标准治疗。如果在长期疾病控制的患者中治疗可以安全地降级为内分泌单药治疗，则没有可用的数据。方法：我们对我们中心接受 CDK4/6 抑制剂和芳香酶抑制剂或氟维司群治疗的 22 名患者的临床病程进行了回顾性分析。所有患者至少在 #x3e;6 个月内疾病稳定，并与他们的提供者共同决定选择性停用 CDK4/6 抑制剂。记录停止治疗时的最佳客观反应 (BOR)、无进展生存期和再治疗特征。结果：在我们中心接受 CDK4/6 抑制剂作为一线或二线治疗的 138 名患者中，22 名符合纳入标准。CDK4/6 治疗的中位持续时间为 18 个月（范围 6-45）。BOR 1 例完全缓解，8 例部分缓解，13 例病情稳定。内分泌单药治疗的中位时间为 9.5 个月（范围 5-44 个月）后，22 名患者中有 6 名出现疾病进展（1 名局部复发和 5 名全身进展）。所有疾病进展的患者对化疗（N = 1）或用 CDK4/6 抑制剂再治疗（N = 4）至少具有稳定的疾病。结论：对于疾病长期稳定的患者，选择性停用 CDK4/6 抑制剂是可行的。该策略应在前瞻性试验中进行评估。
肿瘤资源治疗