5 oktober 2024: Bron: Breast cancer research. Published: Volume 208, pages 223–235, (2024)

Uit een grote retrospectieve studie waarbij de data uit de Amerikaanse registratie gegevens (SEER) werden geanalyseerd op overlijden aan borstkanker blijkt dat de overall overleving van borstkankerpatiënten met HRplus/HER2 negatief sterk verbeterde na de introductie van de zogeheten Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i). Voor borstkankerpatiënten met HR+/HER2plus blijkt er weinig tot geen verschil.
De onderzoekers verklaren dit omdat hun onderzoek dat loopt van 2010 tot 2019 zich richtte op de jaren voor 2015, het jaar waarin de CDK 4/6 remmers werden geintroduceerd, en na 2015 waarin voor de borstkankerpatiënten met HR+/HER2plus er toen ook al op HER2 plus gerichte medicijnen beschikbaar waren.

Resultaten uit het abstract vertaald:

Gegevens van 11.467 vrouwen met HR+/HER2- mBC en 3260 vrouwen met HR+/HER2+ mBC werden opgenomen. Na aanpassing van de baselinekenmerken hadden patiënten met HR+/HER2- mBC die na 2015 werden gediagnosticeerd (n = 6163), een vermindering van ongeveer 10% in het risico op BC-specifieke sterfte vergeleken met patiënten die vóór 2015 werden gediagnosticeerd (n = 5304; HR = 0,895, p < 0,0001). Omgekeerd werd geen significante verandering waargenomen in HR+/HER2+ BCSS na 2015 (n = 1798) versus vóór 2015 (n = 1462). Vergelijkbare resultaten werden gevonden bij patiënten van ≥ 65 jaar.

In onderstaande grafiek de resultaten weergegeven:

figure 1

Het volledige studieverslag is gratis in te zien of te downloaden, klik op de titel van het abstract:

Trends in HR+ metastatic breast cancer survival before and after CDK4/6 inhibitor introduction in the United States: a SEER registry analysis of patients with HER2− and HER2+ metastatic breast cancer

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Abstract

Purpose

Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) have improved patient survival in hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2−) metastatic breast cancer (mBC) in clinical trials and real-world studies. However, investigations of survival gains in broader HR+/HER2− mBC populations using epidemiological approaches are limited.

Methods

This retrospective study used SEER registry data to assess breast cancer-specific survival (BCSS) in patients diagnosed with HR+/HER2− de novo mBC from 2010 to 2019. Kaplan–Meier and Cox proportional hazards models were used to compare BCSS in patients diagnosed before (2010‒2013 with follow-up to 2014) and after (2015‒2018 with follow-up to 2019) the 2015 guideline recommendations for CDK4/6i use. A comparison was made to patients with HR+/HER2-positive (HER2+) de novo mBC, for which no major guideline changes occurred during 2015–2018.

Results

Data from 11,467 women with HR+/HER2− mBC and 3260 women with HR+/HER2+ mBC were included. After baseline characteristic adjustment, patients with HR+/HER2− mBC diagnosed post-2015 (n = 6163), had an approximately 10% reduction in risk of BC-specific death compared with patients diagnosed pre-2015 (n = 5304; HR = 0.895, p < 0.0001). Conversely, no significant change was observed in HR+/HER2+ BCSS post-2015 (n = 1798) versus pre-2015 (n = 1462). Similar results were found in patients aged ≥ 65 years.

Conclusion

Using one of the largest US population-based longitudinal cancer databases, significant improvements in BCSS were noted in patients with HR+/HER2− mBC post-2015 versus pre-2015, potentially due to the introduction of CDK4/6i post-2015. No significant improvement in BCSS was observed in patients with HR+/HER2+ mBC post-2015 versus pre-2015, likely due to the availability of HER2-directed therapies in both time periods.

Data availability

The data that support the findings of this study are available from the National Cancer Institute and can be accessed with permission under a data use agreement.

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Funding

This work was supported by Pfizer Inc. Medical writing support was provided by Kevin Woolfrey, PhD, of Oxford PharmaGenesis Inc., (Newtown, PA, USA) and was funded by Pfizer Inc.

Author information

Authors and Affiliations

  1. UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Adam Brufsky

  2. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA

    Marilyn L. Kwan

  3. Pfizer AB, Stockholm, Sweden

    Rickard Sandin

  4. Pfizer Inc., New York, NY, USA

    Stella Stergiopoulos, Ashley S. Cha-Silva & Doris Makari

  5. RTI Health Solutions, Research Triangle Park, NC, USA

    Siddharth Karanth & Ravi K. Goyal

Contributions

All authors assisted with the development, review and approval of the submitted manuscript.

Corresponding author

Correspondence to Adam Brufsky.

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Competing interest

AB reports consultancy fees from AstraZeneca, Pfizer, Novartis, Lilly, Genentech/Roche, Seagen, Daiichi-Sankyo, Merck, Agendia, Sanofi, and Puma, and provides research support to Agendia and AstraZeneca MLK reports ongoing collaboration on a Pfizer-funded study. SS, RS, AC, DM are employees and stockholders of Pfizer Inc. SK and RKG are full-time employees of RTI Health Solutions, an independent nonprofit research organization, which was a paid consultant to Pfizer in connection with the development of this manuscript. Their compensation is unconnected to the studies on which they work.

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Patient consent was not required for this anonymized, non-interventional study.

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The study was reviewed by the RTI International Institutional Review Board and received a determination of “not research involving human subjects.”

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borstkanker, ER+/HER2 negatief, CDK4/6i remmers, overall overleving, SEER gegevens, Amerikaanse studie


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