Consequences of Discontinuing a 4/6 Cyclin D-Dependent Kinase Inhibitor During Endocrine Treatment in Hormone-Sensitive Metastatic Breast Cancer Patients in the Context of the COVID-19 Outbreak

The impact of some hasty medical decision made during the first wave of the Coronavirus Disease 2019 (COVID-19) remains unknown. We have evaluated the consequences of one of these precautionary measures: the withdrawal of the cyclin D-dependent kinases 4/6 inhibitor (CDK4/6i) in patients whose metas...

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Vydáno v:Clinical breast cancer Ročník 23; číslo 1; s. 32 - 37
Hlavní autoři: Martin, Sophie, Pflumio, Carole, Trensz, Philippe, Schaff-Wendling, Frederique, Weindling, Michal Kalish, Fischbach, Cathie, Pierard, Laure, Limacher, Jean-Marc, Nader, Rita, Velten, Michel, Petit, Thierry
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Elsevier Inc 01.01.2023
Témata:
Antineoplastic Agents - therapeutic use
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Breast Neoplasms - pathology
CDK4/6 inhibitors
COVID-19
Cyclin-Dependent Kinase 4 - antagonists & inhibitors
Cyclin-Dependent Kinase 6 - antagonists & inhibitors
Disease Progression
Female
Hepatic metastases
Hormones
Humans
Neoplasm Metastasis
Original Study
Protein Kinase Inhibitors - administration & dosage
Retrospective Studies
Treatment withdrawn
RR
SBR
OR
OS
CI
Disease progression
ICANS
HR
HER-2
COVID-19
p
LHRH
SARS-CoV-2
CDK4/6 inhibitors
Hepatic metastases
Treatment withdrawn
CDK4/6i
ISSN:1526-8209, 1938-0666, 1938-0666
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Shrnutí:The impact of some hasty medical decision made during the first wave of the Coronavirus Disease 2019 (COVID-19) remains unknown. We have evaluated the consequences of one of these precautionary measures: the withdrawal of the cyclin D-dependent kinases 4/6 inhibitor (CDK4/6i) in patients whose metastatic disease was controlled by a combination of endocrine treatment and CDK 4/6i. This study was noninterventional, retrospective, multicentric, and included 60 patients with HR+ HER2- metastatic disease. Their disease was controlled with the combination of endocrine treatment and CDK 4/6i. The CDK 4/6i was stopped for two months during the first COVID-19 outbreak. A univariate analysis was performed to assess the risk factors associated with disease progression. During this therapeutic break, 22 (37 %) patients had a radiological and/or clinical disease progression. Among them, the CDK 4/6i was re-introduced to 16 patients (n = 16/22; 73 %). A new line of treatment (chemotherapy or targeted therapy) was initiated due to the rapid symptomatic tumor progression in four patients (n = 4/22; 18 %). Two patients (n = 2/22) died in visceral crisis before another anti-tumoral treatment was introduced. In univariate analysis, the presence of liver metastases increased the risk of metastatic disease progression during the withdrawal of the CDK 4/6 (OR = 6.6; 95 % CI 1.87-23.22; P= .0033). Progression was observed in 37% of patients during the two-month treatment interruption of the CDK 4/6i. A prolonged CDK 4/6i treatment interruption in patients with clinical benefit on endocrine treatment does not seem to be a reasonable option in light of these results. The impact of some oncology interventions taken hastily during the COVID-19 first wave remains unknown. This non-interventional, retrospective, multicentric study was conducted to assess the consequences of CDK 4/6i interruption in patients with metastatic breast cancer. Results showed disease progression in 37% of patients, and the risk of metastatic disease progression was significantly increased for patients with liver metastases.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1526-8209
1938-0666
1938-0666
DOI:10.1016/j.clbc.2022.10.006