CDK4/6 inhibitors: The Devil is in the Detail

Purpose of review Update on the most recent clinical evidence on CDK4/6 inhibitors (CDK4/6i) in the treatment of hormone receptor (HR)-positive, human epidermal growth factor receptor (HER)2-negative breast cancer. Recent findings Over the past decade, CDK4/6i have become part of the standard of car...

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Bibliographic Details
Published in:Current oncology reports 2024-06, Vol.26 (6), p.665-678
Main Authors: Magge, Tara, Rajendran, Sneha, Brufsky, Adam M., Foldi, Julia
Format: Article
Language:English
Subjects:
Aminopyridines - therapeutic use
Benzimidazoles
Breast cancer
Breast Neoplasms - drug therapy
Breast Neoplasms - pathology
Cyclin-dependent kinase 4
Cyclin-Dependent Kinase 4 - antagonists & inhibitors
Cyclin-Dependent Kinase 6 - antagonists & inhibitors
Endocrine therapy
ErbB-2 protein
Female
Humans
Medicine
Medicine & Public Health
Metastases
Metastasis
Oncology
Patients
Protein Kinase Inhibitors - therapeutic use
Purines - pharmacology
Purines - therapeutic use
Review
Survival
Topical Collection on Breast Cancer
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Summary:Purpose of review Update on the most recent clinical evidence on CDK4/6 inhibitors (CDK4/6i) in the treatment of hormone receptor (HR)-positive, human epidermal growth factor receptor (HER)2-negative breast cancer. Recent findings Over the past decade, CDK4/6i have become part of the standard of care treatment of patients with both metastatic and high-risk early HR + /HER2- breast cancers. The three available CDK4/6i (palbociclib, ribociclib and abemaciclib) have been extensively studied in combination with endocrine therapy (ET) in metastatic breast cancer (mBC) with consistent prolongation of progression free survival; however, ribociclib has emerged as the preferred first line agent in mBC given overall survival benefit over endocrine monotherapy. In early BC, abemaciclib is the only currently approved agent while ribociclib has early positive clinical trial data. Toxicities and financial burden limit the use of CDK4/6i in all patients and resource-poor settings, and optimal timing of their use in mBC remains unclear. Summary There is considerable evidence for the use of CDK4/6i in metastatic and early HR + /HER2- breast cancer, but knowledge gaps remain, and further research is necessary to better define their optimal use.
ISSN:1523-3790
1534-6269
1534-6269
DOI:10.1007/s11912-024-01540-7