Palbociclib and beyond for the treatment of HR + HER2- metastatic breast cancer: an Asian-Pacific perspective and practical management guide on the use of CDK4/6 inhibitors
Journal
Current Medical Research and Opinion
Journal Volume
36
Journal Issue
8
Pages
1363-1373
Date Issued
2020
Author(s)
Abstract
Breast cancer is the most frequent cancer amongst women worldwide including in Asia where the incidence rate is rapidly increasing. Even with treatment, around 30% of patients with early breast cancer progress to metastatic disease, with hormone receptor positive (HR+) and human epidermal growth factor receptor 2 negative (HER2-) breast cancer the most common phenotype. First-line endocrine therapy targeting the estrogen receptor signaling pathway provides a median progression-free survival or time to progression of 6–15 months in HR + HER2- metastatic breast cancer. Recently, cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors, combined with endocrine therapy, have achieved more than two years median progression-free survival in HR + HER2- metastatic breast cancer. However, the characteristics of the Asian breast cancer population differ from those of Western populations and need to be considered when selecting a suitable treatment. Breast cancer is diagnosed at a younger age in Asian populations and late stage at presentation is generally more common in low-/middle-income countries than high-income countries. Consequently, the proportion of premenopausal women with metastatic breast cancer is higher in Asian compared with Western populations. While CDK4/6 inhibitors have been approved in the USA (FDA) since 2015, experience with them in Asia is more limited. We review the experience with the CDK4/6 inhibitor palbociclib in Asian patients with HR + HER2- metastatic breast cancer and provide guidance on the use of palbociclib in these patients. ? 2020 Informa UK Limited, trading as Taylor & Francis Group.
Subjects
Asia Pacific; Breast cancer; CDK4/6 inhibitor; endocrine therapy; hormone receptor positive; palbociclib; practical guidance
Other Subjects
abemaciclib; cyclin dependent kinase 4; cyclin dependent kinase 6; cyclin dependent kinase inhibitor; epidermal growth factor receptor 2; estrogen receptor; hormone receptor; palbociclib; ribociclib; cyclin dependent kinase 4; cyclin dependent kinase 6; epidermal growth factor receptor 2; ERBB2 protein, human; estrogen receptor; palbociclib; piperazine derivative; protein kinase inhibitor; pyridine derivative; Asian; cancer chemotherapy; cancer hormone therapy; drug efficacy; hormonal therapy; human; liver metastasis; metastatic breast cancer; ovary function; premenopause; Review; signal transduction; adult; breast tumor; female; metastasis; middle aged; mortality; pathology; Adult; Breast Neoplasms; Cyclin-Dependent Kinase 4; Cyclin-Dependent Kinase 6; Female; Humans; Middle Aged; Neoplasm Metastasis; Piperazines; Progression-Free Survival; Protein Kinase Inhibitors; Pyridines; Receptor, ErbB-2; Receptors, Estrogen
Publisher
Taylor and Francis Ltd
Type
review