Subscribe

Subscribe Today!

To sign up for our newsletter or print publications, please enter your contact information below.

I'd like to receive:

CDK4/6 Inhibitor Treatment Patterns and Outcomes in Metastatic Breast Cancer by Germline BRCA Mutation Status: A Real-World Evidence Study

2021 Year in Review - Breast Cancer - Breast Cancer

There are little data on real-world treatment patterns and the efficacy of cyclin-dependent kinase (CDK)4/6 inhibitors in germline BRCA mutation–positive breast cancer. Adults with hormone receptor (HR)-positive, HER2-negative, metastatic breast cancer treated with CDK4/6 inhibitor therapy were retrospectively identified from the Flatiron Health Analytics database between 2013 and 2018. Patients with known germline BRCA status were divided into 2 groups: BRCA mutation–positive and BRCA wild-type. From the time of initiation of the first line of therapy with a CDK4/6 inhibitor, overall survival and the time to first subsequent therapy or death were calculated.1

Of the 2968 patients with HR-positive, HER2-negative metastatic breast cancer who were treated with a CDK4/6 inhibitor, 28.9% had known germline BRCA status, with 9.9% having BRCA mutation–positive disease and 90.1% having BRCA wild-type disease.1

Metastatic breast cancer is treatable but not curable. Surgical and radiation therapy, as well as hormone therapy, chemotherapy, targeted medicines, or a combination of these therapies may be indicated depending on the metastatic breast cancer subtype. Targeted cancer therapies affect specific oncogenic molecular pathways and have shown significant clinical effectiveness in patients with metastatic breast cancer, generally with a lower toxicity profile than traditional toxic chemotherapy.2

Although various medicines have been developed to target HER2, they are only appropriate for the approximately 20% of patients with breast cancer who have HER2-positive disease. CDK4/6 inhibitors are a form of targeted therapy used to treat HR-positive, HER2-negative metastatic breast cancer, which accounts for approximately 68% of all female breast malignancies. In February 2015, the first CDK4/6 inhibitor, palbociclib, was licensed in the United States for the treatment of patients with HR-positive, HER2-negative metastatic breast cancer, followed by ribociclib and abemaciclib in 2017.2 Oral oncolytics such as CDK4/6 inhibitors are preferred by some patients over injections and infusions for a variety of reasons, including convenience, improved sense of control, and fewer injection-site problems. While oral oncolytics have some benefits, patient self-administration of oral therapy shifts medication management from healthcare providers to patients, potentially raising concerns about patients’ ability and willingness to adhere to a prescribed regimen as directed by their healthcare provider or to take them for the prescribed duration.2

This finding emphasizes the unmet need for better treatment selection and sequencing in patients with germline BRCA mutation–positive disease. Larger samples of patients who have had biomarker testing should be studied in the future.1

References

  1. Collins JM, Nordstrom BL, McLaurin KK, et al. A real-world evidence study of CDK4/6 inhibitor treatment patterns and outcomes in metastatic breast cancer by germline BRCA mutation status. Oncol Ther. 2021;9:575-589.
  2. Stephenson JJ, Gable JG, Zincavage R, et al. Treatment experiences with CDK4&6 inhibitors among women with metastatic breast cancer: a qualitative study. Patient Prefer Adherence. 2021;15:2417-2429.
Related Items
Enhertu Received Regular FDA Approval for Patients with Unresectable or Metastatic Breast Cancer
JHOP - June 2022 Vol 12, No 3 published on June 16, 2022 in FDA Oncology Update, Breast Cancer
Lynparza Receives FDA Approval for Adjuvant Treatment of High-Risk Early Breast Cancer with BRCA Mutation
JHOP - April 2022 Vol 12, No 2 published on May 3, 2022 in FDA Oncology Update, Breast Cancer
Pembrolizumab plus Chemotherapy for Neoadjuvant and Adjuvant Therapy in Early Triple-Negative Breast Cancer: KEYNOTE-522
Robert J. Ignoffo, PharmD, FASHP, FCSHP, FHOPA
JHOP - April 2022 Vol 12, No 2 published on May 3, 2022 in From the Literature, Breast Cancer, Checkpoint Inhibitors
Evaluating Adverse Events in Patients with Breast Cancer and HIV Infection Receiving Concomitant Antiretroviral Therapy and Chemotherapy with Curative Intent
Donyika Joseph, PharmD, BCOP, Farnaz Foolad, PharmD, BCPS, Neelam K. Patel, PharmD, BCOP, Meghan Karuturi, MD, MSc, Jaime Kaushik, PharmD, BCOP
JHOP - April 2022 Vol 12, No 2 published on May 2, 2022 in Original Article, Adverse Events, Breast Cancer, Infections
Advances in Breast Cancer Treatments: Are We Extending Patients’ Survival?
Meg Barbor, MPH
JHOP - June 2019 Vol 9, No 2 published on April 28, 2022 in HOPA Highlights, Breast Cancer
Development and Implementation of a Pharmacist-Led Virtual Clinic Improve the Management of Patients with Metastatic Breast Cancer Receiving CDK4/6 Inhibitors
JHOP - March 2022 Vol 12 Special Feature published on March 22, 2022 in HOPA Abstracts, Breast Cancer
Time to Treatment Initiation and Outcomes for Patients with Nonmetastatic Breast Cancer Before and During the COVID-19 Pandemic at Community Cancer Centers
JHOP - March 2022 Vol 12 Special Feature published on March 22, 2022 in HOPA Abstracts, Breast Cancer
Spontaneous Tumor Lysis Syndrome in a Patient with Stage IV HER2-Positive Breast Cancer: Case Report
Blake T. Robbins, PharmD, MBA , Alexander M. Kreimer, PharmD, BCPS , Reema A. Patel, MD, Allison R. Butts, PharmD, BCOP
JHOP - February 2022 Vol 12, No 1 published on March 1, 2022 in Case Reports, Tumor Lysis Syndrome, Breast Cancer
Sacituzumab Govitecan Moves to Second-Line Therapy for Metastatic Triple-Negative Breast Cancer: Applying the Lessons from Clinical Trials to Clinical Practice
February 2022 Clinical Trials to Clinical Practice published on February 3, 2022 in Clinical Trials, Breast Cancer
2021 Breast Cancer Year in Review Introduction
2021 Year in Review - Breast Cancer published on January 21, 2022 in Breast Cancer
Copyright © The Lynx Group, LLC. All rights reserved.