Efficacy of radiotherapy for bone metastasis in breast cancer patients treated with cyclin-dependent kinase 4/6 inhibitors.

Autor: Kubeczko M; Breast Cancer Center, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland., Gabryś D; Department of Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland. Electronic address: dorota.gabrys@gliwice.nio.gov.pl., Rembak-Szynkiewicz J; Department of Radiologic and Diagnostic Imaging, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland., Gräupner D; III Department of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland., Polakiewicz-Gilowska A; Breast Cancer Center, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland., Jarząb M; Breast Cancer Center, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-102 Gliwice, Poland.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2024 Nov 19; Vol. 202, pp. 110639. Date of Electronic Publication: 2024 Nov 19.
DOI: 10.1016/j.radonc.2024.110639
Abstrakt: Background: In patients diagnosed withestrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer, bone metastasesemerge as theprimary siteofsignificant tumor burden. Cyclin-dependent kinase 4/6 (CDK4/6i) inhibitorsare thegold standard in this clinical scenario, while radiotherapy (RT) represents a valuable addition. However, data on the efficacy of this combination remain scarce. We aimed to evaluate efficacy of RT in bone metastatic breast cancer patients treated with CDK4/6 inhibitors.
Materials and Methods: 398 patients (pts) with ER-positive HER2-negative breast cancer with bone metastases treated with CDK4/6i between 2018-2024 were analyzed. A total of 114 pts received 177 bone RT concurrently with CDK4/6i or within 6 months before CDK4/6i initiation, including 34 courses of stereotactic-body RT and 143 courses of conventional RT.
Results: The median progression-free survival (PFS) in pts who received bone RT was 31.0 months, compared to 26.3 months in pts without bone RT. The 2-y PFS for pts with bone RT was 57.1 % [95 % CI: 46.3-66.6 %] vs. 53.2 % [95 % CI: 46.3-59.6 %] for patients without bone RT (p = 0.51). The median overall survival (OS) for pts who received bone RT was 49.1 months, compared to 40.5 months for pts without bone RT. The 3-y OS for pts with bone RT was 63.7 % [95 % CI: 51.5-73.5 %] vs. 55.0 % [95 % CI 46.6-62.6 %] for pts without bone RT (p = 0.50). The 3-y local control for irradiated patients was 86.9 % [95 % CI 72.2-94.1 %].
Conclusions: In this study, we present the largest cohort published to date of breast cancer patients who received CDK4/6i alongside bone-directed RT. Although the observed differences in survival were not statistically significant, RT remains a viable treatment modality in metastatic breast cancer in some patients.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Marcin Kubeczko declares advisory board for Novartis; speaker's honoraria from Novartis, Roche, Lilly, Teva, Amgen, Swixx Biopharma, and Gilead; clinical trials for Roche, MSD, Novartis, Seagen, and Gilead; conference fees from Pfizer, Roche, Novartis, Teva, Amgen, Gilead, MSD and Swixx Biopharma; all outside the submitted work. Dorota Gabry{\acute{s}}. reports a relationship with Clinical Education EMEA Varian, a Siemens Healthineers Company that includes speaking and lecture fees; all outside the submitted work. Anna Polakiewicz-Gilowska declares conferences fees for Pfizer, clinical trials for Roche, MSD, Novartis, Seagen, Gilead; speaker's honorarium: Pfizer, Novartis, Gilead; all outside the submitted work. Michał Jarząb declares conference fees for Gilead, Roche; clinical trials for Roche, MSD, Novartis, Seagen, and Gilead; speaker's honoraria from Novartis, Roche, Lilly, Pfizer, Teva, Exact Sciences, Mammotome, and Gilead; advisory boards for Novartis and Pfizer; all outside submitted work. Other Authors declares no competing interests..
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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