CDK4/6 inhibitors rechallenge post-progression in HR-positive HER2-negative advanced/metastatic breast cancer patients: a meta-analysis of Kaplan-Meier-reconstructed individual-level data.
Summary
This meta-analysis investigated the efficacy of rechallenging with CDK4/6 inhibitors (CDK4/6i) after progression in patients with HR-positive, HER2-negative advanced/metastatic breast cancer. The study included 1396 patients from eight clinical trials, comparing CDK4/6i rechallenge plus endocrine therapy to endocrine therapy alone. Results indicated a significant improvement in median progression-free survival (PFS) of 5.8 months versus 3.7 months. A greater benefit was observed when switching to a different CDK4/6 inhibitor, particularly with abemaciclib, but no overall survival benefit was demonstrated.
Analysis
This meta-analysis is crucial as it provides strong evidence supporting the rechallenge with CDK4/6 inhibitors in patients with HR-positive, HER2-negative advanced breast cancer after initial progression. It suggests that a rechallenge strategy, particularly with a switch to a different inhibitor like abemaciclib, can prolong progression-free survival, offering an additional therapeutic option in a setting where choices are limited. Although no overall survival benefit was observed, the improvement in PFS is clinically relevant for disease management and patient quality of life.