Advancing treatment choices: CDK4/6 inhibitor switching in HR+/HER2- metastatic breast cancer
Purpose: CDK4/6 inhibitors (CDK4/6i) use has revolutionized the treatment of hormone receptor-positive/human epidermal growth factor receptor 2 negative (HR+/HER2-) metastatic breast cancer. The choice of a specific CDK4/6i may be influenced by adverse events (AEs). Recently, the Italian Medicines A...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-02-01
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| Series: | Breast |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0960977625000049 |
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| author | Paola Zagami Angela Esposito Beatrice Taurelli Salimbeni Pier Paolo Maria Berton Giachetti Roberta Scafetta Matteo Lambertini Massimo Di Maio Giuseppe Curigliano Carmen Criscitiello Saverio Cinieri |
| author_facet | Paola Zagami Angela Esposito Beatrice Taurelli Salimbeni Pier Paolo Maria Berton Giachetti Roberta Scafetta Matteo Lambertini Massimo Di Maio Giuseppe Curigliano Carmen Criscitiello Saverio Cinieri |
| author_sort | Paola Zagami |
| collection | DOAJ |
| description | Purpose: CDK4/6 inhibitors (CDK4/6i) use has revolutionized the treatment of hormone receptor-positive/human epidermal growth factor receptor 2 negative (HR+/HER2-) metastatic breast cancer. The choice of a specific CDK4/6i may be influenced by adverse events (AEs). Recently, the Italian Medicines Agency (AIFA) approved the possibility of switching between CDK4/6i for unacceptable toxicity. This study explores oncologists' experiences and future perspectives on CDK4/6 inhibitor switching following this new approval. Methods: With the support of the Italian Association of Medical Oncology (AIOM), we conducted a survey among 92 oncologists to assess the impact of AIFA's approval on patient management. Results: The survey showed that 48 % of participants were not surprised regarding AIFA's decision, with 76 % of respondents believing that this opportunity would significantly influence their treatment choices, enhancing AEs management for patients. Yet, 49 % of respondents emphasized the need for more real world evidence on CDK4/6i switch safety and efficacy. 96 % of respondents reported discontinuation rates between 0% and 25 % of patients, with constipation and hematological toxicity being the most frequent treatment discontinuation reasons. The oncologists prescribing CDK4/6i switch reported that most of these patients were in first line treatment (85 %) and the most common second CDK4/6i most frequently initiated was palbociclib (69 %), then abemaciclib (17 %) and ribociclib (14 %). Among those who started the second CDK4/6i at full dosage, 66 % of patients didn't require a dose reduction. Conclusion: Our survey highlights the importance of allowing CDK4/6i switching, thus likely prompting oncologists to adapt their treatment choices, leading to better AEs management for improving patients’ outcome. |
| format | Article |
| id | doaj-art-d4f37c496eb84299a252cd88aa2d4b58 |
| institution | Kabale University |
| issn | 1532-3080 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Breast |
| spelling | doaj-art-d4f37c496eb84299a252cd88aa2d4b582025-02-12T05:30:38ZengElsevierBreast1532-30802025-02-0179103875Advancing treatment choices: CDK4/6 inhibitor switching in HR+/HER2- metastatic breast cancerPaola Zagami0Angela Esposito1Beatrice Taurelli Salimbeni2Pier Paolo Maria Berton Giachetti3Roberta Scafetta4Matteo Lambertini5Massimo Di Maio6Giuseppe Curigliano7Carmen Criscitiello8Saverio Cinieri9Department of Oncology and Hematology, University of Milano, Milan, Italy; Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, Milan, ItalyDivision of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, Milan, ItalyDivision of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, Milan, ItalyDepartment of Oncology and Hematology, University of Milano, Milan, Italy; Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, Milan, ItalyDepartment of Medical Oncology, Campus Bio-Medico University of Rome, Rome, ItalyDepartment of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy; Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, ItalyDepartment of Oncology, University of Turin, Division of Medical Oncology, Ordine Mauriziano Hospital, Turin, ItalyDepartment of Oncology and Hematology, University of Milano, Milan, Italy; Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, Milan, ItalyDepartment of Oncology and Hematology, University of Milano, Milan, Italy; Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, Milan, Italy; Corresponding author. European Institute of Oncology IRCCS, Via Ripamonti 435 University of Milano, Milan, Italy Milan Italy, 20141, Milan, Italy.Medical Oncology Division and Breast Unit, Senatore Antonio Perrino Hospital, ASL Brindisi, Brindisi, ItalyPurpose: CDK4/6 inhibitors (CDK4/6i) use has revolutionized the treatment of hormone receptor-positive/human epidermal growth factor receptor 2 negative (HR+/HER2-) metastatic breast cancer. The choice of a specific CDK4/6i may be influenced by adverse events (AEs). Recently, the Italian Medicines Agency (AIFA) approved the possibility of switching between CDK4/6i for unacceptable toxicity. This study explores oncologists' experiences and future perspectives on CDK4/6 inhibitor switching following this new approval. Methods: With the support of the Italian Association of Medical Oncology (AIOM), we conducted a survey among 92 oncologists to assess the impact of AIFA's approval on patient management. Results: The survey showed that 48 % of participants were not surprised regarding AIFA's decision, with 76 % of respondents believing that this opportunity would significantly influence their treatment choices, enhancing AEs management for patients. Yet, 49 % of respondents emphasized the need for more real world evidence on CDK4/6i switch safety and efficacy. 96 % of respondents reported discontinuation rates between 0% and 25 % of patients, with constipation and hematological toxicity being the most frequent treatment discontinuation reasons. The oncologists prescribing CDK4/6i switch reported that most of these patients were in first line treatment (85 %) and the most common second CDK4/6i most frequently initiated was palbociclib (69 %), then abemaciclib (17 %) and ribociclib (14 %). Among those who started the second CDK4/6i at full dosage, 66 % of patients didn't require a dose reduction. Conclusion: Our survey highlights the importance of allowing CDK4/6i switching, thus likely prompting oncologists to adapt their treatment choices, leading to better AEs management for improving patients’ outcome.http://www.sciencedirect.com/science/article/pii/S0960977625000049Breast cancerCDK4-6iMetastatic treatment and endocrine-based therapy |
| spellingShingle | Paola Zagami Angela Esposito Beatrice Taurelli Salimbeni Pier Paolo Maria Berton Giachetti Roberta Scafetta Matteo Lambertini Massimo Di Maio Giuseppe Curigliano Carmen Criscitiello Saverio Cinieri Advancing treatment choices: CDK4/6 inhibitor switching in HR+/HER2- metastatic breast cancer Breast Breast cancer CDK4-6i Metastatic treatment and endocrine-based therapy |
| title | Advancing treatment choices: CDK4/6 inhibitor switching in HR+/HER2- metastatic breast cancer |
| title_full | Advancing treatment choices: CDK4/6 inhibitor switching in HR+/HER2- metastatic breast cancer |
| title_fullStr | Advancing treatment choices: CDK4/6 inhibitor switching in HR+/HER2- metastatic breast cancer |
| title_full_unstemmed | Advancing treatment choices: CDK4/6 inhibitor switching in HR+/HER2- metastatic breast cancer |
| title_short | Advancing treatment choices: CDK4/6 inhibitor switching in HR+/HER2- metastatic breast cancer |
| title_sort | advancing treatment choices cdk4 6 inhibitor switching in hr her2 metastatic breast cancer |
| topic | Breast cancer CDK4-6i Metastatic treatment and endocrine-based therapy |
| url | http://www.sciencedirect.com/science/article/pii/S0960977625000049 |
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