December 2021: CDK4/6 inhibitors in the treatment of patients with early breast cancer

CDK4/6 inhibition represents a fundamental new treatment approach to improve endocrine therapy. While the role of CDK4/6 inhibitors is well established in metastatic breast cancer their use in early breast cancer is still less clear.

Abstract:

CDK4/6 inhibitors have an established role in the treatment of hormone receptor positive HER2-negative advanced breast cancer. All studies conducted in metastatic breast cancer showed a benefit in delaying progression when added to standard endocrine therapy, regardless of therapy line, pretreatment, menopausal status, site of metastasis, CDK4/6 inhibitor used and associated endocrine therapy. A benefit in overall survival has also been demonstrated. In early breast cancer, only the MonarchE study has shown an improved invasive disease-free survival with abemaciclib taken for 2 years, whereas the Penelope-B did not meet the primary endpoint and the PALLAS study was terminated early for futility. Studies conducted in the neoadjuvant setting might help to explain the discordant results.

Loibl S, Furlanetto J. Integrating CDK4/6 inhibitors in the treatment of patients with early breast cancer. Breast. 2021; doi: 10.1016/j.breast.2021.12.008.

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