TY - JOUR
T1 - Safety profile of cyclin-dependent kinase (CDK) 4/6 inhibitors with concurrent radiation therapy
T2 - A systematic review and meta-analysis
AU - Becherini, Carlotta
AU - Visani, Luca
AU - Caini, Saverio
AU - Bhattacharya, Indrani S.
AU - Kirby, Anna M.
AU - Nader Marta, Gustavo
AU - Morgan, Gilberto
AU - Salvestrini, Viola
AU - Coles, Charlotte E.
AU - Cortes, Javier
AU - Curigliano, Giuseppe
AU - de Azambuja, Evandro
AU - Harbeck, Nadia
AU - Isacke, Clare M.
AU - Kaidar-Person, Orit
AU - Marangoni, Elisabetta
AU - Offersen, Birgitte
AU - Rugo, Hope S.
AU - Morandi, Andrea
AU - Lambertini, Matteo
AU - Poortmans, Philip
AU - Livi, Lorenzo
AU - Meattini, Icro
N1 - Funding Information:
Authors would like to acknowledge Tessa Piazzini and Alida Daniele (Biblioteca Biomedica, University of Florence, Florence, Italy) for their contribution to the literature search. Research data are stored and will be shared upon request to the corresponding author. Charlotte E. Coles CEC is funded by the National Institute of Health and Social Care Research (NIHR) and supported by the NIHR Cambridge Biomedical Research Centre; the views expressed are those of the author and not necessarily those of the NIHR or the Department of Health and Social Care.
Funding Information:
Authors would like to acknowledge Tessa Piazzini and Alida Daniele (Biblioteca Biomedica, University of Florence, Florence, Italy) for their contribution to the literature search. Research data are stored and will be shared upon request to the corresponding author. Charlotte E. Coles CEC is funded by the National Institute of Health and Social Care Research (NIHR) and supported by the NIHR Cambridge Biomedical Research Centre; the views expressed are those of the author and not necessarily those of the NIHR or the Department of Health and Social Care.
Publisher Copyright:
© 2023 Elsevier Ltd
PY - 2023/9/1
Y1 - 2023/9/1
N2 - The cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) have become the standard of care for hormone receptor-positive (HR + ) and human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer, improving survival outcomes compared to endocrine therapy alone. Abemaciclib and ribociclib, in combination with endocrine therapy, have demonstrated significant benefits in invasive disease-free survival for high-risk HR+/HER2- early breast cancer patients. Each CDK4/6i—palbociclib, ribociclib, and abemaciclib—exhibits distinct toxicity profiles. Radiation therapy (RT) can be delivered with a palliative or ablative intent, particularly using stereotactic body radiation therapy for oligometastatic or oligoprogressive disease. However, pivotal randomized trials lack information on concomitant CDK4/6i and RT, and existing preclinical and clinical data on the potential combined toxicities are limited and conflicting. As part of a broader effort to establish international consensus recommendations for integrating RT and targeted agents in breast cancer treatment, we conducted a systematic review and meta-analysis to evaluate the safety profile of combining CDK4/6i with palliative and ablative RT in both metastatic and early breast cancer settings.
AB - The cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) have become the standard of care for hormone receptor-positive (HR + ) and human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer, improving survival outcomes compared to endocrine therapy alone. Abemaciclib and ribociclib, in combination with endocrine therapy, have demonstrated significant benefits in invasive disease-free survival for high-risk HR+/HER2- early breast cancer patients. Each CDK4/6i—palbociclib, ribociclib, and abemaciclib—exhibits distinct toxicity profiles. Radiation therapy (RT) can be delivered with a palliative or ablative intent, particularly using stereotactic body radiation therapy for oligometastatic or oligoprogressive disease. However, pivotal randomized trials lack information on concomitant CDK4/6i and RT, and existing preclinical and clinical data on the potential combined toxicities are limited and conflicting. As part of a broader effort to establish international consensus recommendations for integrating RT and targeted agents in breast cancer treatment, we conducted a systematic review and meta-analysis to evaluate the safety profile of combining CDK4/6i with palliative and ablative RT in both metastatic and early breast cancer settings.
KW - Breast cancer
KW - CDK4/6 inhibitors
KW - Meta-analysis
KW - Radiotherapy
KW - Systematic review
KW - Toxicity
U2 - 10.1016/j.ctrv.2023.102586
DO - 10.1016/j.ctrv.2023.102586
M3 - (Systematic) Review article
C2 - 37336117
SN - 0305-7372
VL - 119
JO - Cancer Treatment Reviews
JF - Cancer Treatment Reviews
IS - 1
M1 - 102586
ER -