Treatment of Luminal Metastatic Breast Cancer beyond CDK4/6 Inhibition: Is There a Standard of Care in Clinical Practice?
Background: CDK4/6 inhibitors have become the standard for first-line treatment of metastatic luminal breast cancer based on consistent data from several phase 3 trials demonstrating clinically meaningful improvement of progression-free as well as overall survival. In addition, they are about to bec...
| Publicado en: | Breast Care Vol. 16; no. 2; pp. 115 - 129 |
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| Autores principales: | , |
| Formato: | review tables/charts Journal Article |
| Publicado: |
Karger AG
2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=149946167&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 149946167 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 16613791 1WIC jtl: Breast Care issn: 16613791 maglogo: N pubinfo: dt: 2021 vid: 16 iid: 2 pid: 2485 pub: Karger AG artinfo: ui: 149946167 149946167 149946167 10.1159/000514561 149946167 ppf: 115 ppct: 14 formats: tig: atl: Treatment of Luminal Metastatic Breast Cancer beyond CDK4/6 Inhibition: Is There a Standard of Care in Clinical Practice? aug: au: Mavratzas, Athanasios Marmé, Frederik affil: Section of Conservative Gynecologic Oncology, Experimental and Translational Gynecologic Oncology, Medical Faculty Mannheim, Heidelberg University, Department of Obstetrics and Gynecology, University Hospital Mannheim, Mannheim, Germany sug: subj: Neoplasm Metastasis Therapy Breast Neoplasms Therapy Transferases Metabolism Oncologic Care Standards Antineoplastic Agents Adverse Effects Antineoplastic Agents Therapeutic Use Antineoplastic Agents Administration and Dosage Intracellular Signaling Peptides and Proteins ab: Background: CDK4/6 inhibitors have become the standard for first-line treatment of metastatic luminal breast cancer based on consistent data from several phase 3 trials demonstrating clinically meaningful improvement of progression-free as well as overall survival. In addition, they are about to become a part of adjuvant treatment for patients with high-risk luminal disease based on positive results from the first randomized phase 3 trial on abemaciclib. Nevertheless, the majority of patients with advanced or metastatic luminal breast cancer and prospectively a relevant proportion of patients treated in the adjuvant setting will eventually develop resistance to this endocrine based combination within 12–36 months, depending on the line of treatment. Conclusion: Potential subsequent therapies include PI3K inhibitors, mTOR inhibitors, endocrine monotherapy, PARP inhibitors, and chemotherapy. However, these therapies have mainly been developed in the pre-CDK4/6 inhibitor era and little is known about potential cross-resistance. The concept of continuing CDK4/6 inhibition beyond progression is supported by some preclinical data, but to date there is very limited clinical evidence to support this strategy. Therefore, treatment of metastatic luminal breast cancer after progression on CDK4/6 inhibitors remains a challenge. Key Messages: Here we review current evidence from pro- and retrospective studies and give an outlook on future developments with respect to novel therapeutic agents, including oral SERD and AKT inhibitors, which have the potential to change the therapeutic landscape in the future. Furthermore, clinical treatment algorithms and current research will also be discussed. pubtype: Academic Journal doctype: review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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