VIDEO: Study provides real-world data on treatment sequencing in breast cancer subset
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Megan Kruse, MD, a breast medical oncologist at Cleveland Clinic, spoke with Healio about results from her research on real-world sequential and non-sequential use of CDK4/6 inhibitors in a subset of breast cancer patients.
The results were presented at San Antonio Breast Cancer Symposium.
“This idea for research came about, really, from a clinical question that I think a lot of medical oncologists think about each day, which is what to do for patients who have been treated in the first-line, metastatic, [hormone receptor]-positive HER2-negative breast cancer setting with a CKD4/6 inhibitor and some sort of endocrine therapy,” Kruse said. “And we really struggle knowing what to do next, because there are not great studies that inform a sequencing choice.”
Through examining real-world experience among these patients, she said researchers found that many patients who had previously received CDK4/6 inhibitors continued receiving CDK4/6 inhibitors as second- or third-line treatments.
Additionally, the researchers found that patients who were sensitive to combination treatment with endocrine therapy plus CDK4/6 inhibitors as a first- or second-line treatment had improved PFS when they received CDK4/6 inhibitors as a subsequent treatment compared with those who did not receive later treatment with CDK4/6 inhibitors.
Among patients who did not have good outcomes with a combined treatment of endocrine therapy plus CDK4/6, “it seems like providers are more likely to switch them to a different type of therapy,” such as chemotherapy, Kruse said.
“I think that’s the main takeaway, that if you get a good response with your first exposure to this combination therapy, you’re more likely to have a response in the next sequential line of therapy,” Kruse said. “But we don’t really know all the details involved in that, particularly which CDK4/6 inhibitor to use — is there an optimal way to sequence the drugs within this class — we really have no idea. The granularity of our data was not able to parce out those very specific differences, and I think those are going to be really relevant as providers make decisions moving forward.”
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