PMID- 27001208
OWN - NLM
STAT- MEDLINE
DCOM- 20161025
LR  - 20181202
IS  - 1743-7563 (Electronic)
IS  - 1743-7555 (Linking)
VI  - 12 Suppl 1
DP  - 2016 Mar
TI  - Hormone receptor positive, HER2 negative metastatic breast cancer: A systematic 
      review of the current treatment landscape.
PG  - 3-18
LID - 10.1111/ajco.12491 [doi]
AB  - Endocrine therapy for the treatment of hormone receptor positive, HER2 negative, 
      metastatic breast cancer is continually evolving. We systematically reviewed 
      phase 2 and 3 randomized controlled trials (RCTs) of agents used in this setting 
      to assess the effectiveness and safety of these agents for postmenopausal women. 
      Across the 32 studies in more than 10,000 patients, the greatest improvement in 
      progression-free survival (PFS) was seen with the addition of a cyclin-dependent 
      kinase (CDK)4/6 inhibitor to standard endocrine therapy. Treatment with a 
      mammalian target of rapamycin (mTOR) inhibitor, phosphoinositol-3-kinase (Pi3K) 
      inhibitor, vascular endothelial growth factor (VEGF) inhibitor and with a 
      selective estrogen receptor degrader (SERD) also showed benefit in PFS for 
      selected trials. Overall survival (OS) improved with the use of mTOR inhibitors 
      and a SERD; however, studies were not powered for an OS endpoint. Encouraging 
      results from early studies of histone deacetylase (HDAC) and B-cell lymphoma 
      (BCL2) inhibitors are yet to be confirmed in phase III clinical trials. Study 
      discontinuation rates and toxicity-related deaths were highest with VEGF 
      inhibitors in combination with endocrine therapy, limiting their use in hormone 
      receptor positive breast cancer. CDK4/6 inhibitors and mTOR inhibitors appeared 
      to have activity in both first and second line settings, but required additional 
      monitoring for common toxicities. The activity of epidermal growth factor 
      receptor (EGFR) tyrosine kinase inhibitors was limited to the first-line setting 
      and treatment discontinuation rates were higher than with mTOR inhibitors and 
      SERDs. Overall, PFS benefit appears to be greatest when agents acting on CDK4/6, 
      mTOR and Pi3K pathways, and SERDs are added to standard endocrine therapy. If 
      these early results persist in further studies, these data are likely to change 
      the way we treat hormone receptor positive, HER2 negative metastatic breast 
      cancer. In the follow-up article to this review, we will consider the potential 
      future treatment options for these patients.
CI  - (c) 2016 John Wiley & Sons Australia, Ltd.
FAU - Beith, Jane
AU  - Beith J
AD  - Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.
FAU - Burslem, Katie
AU  - Burslem K
AD  - Write Source Medical Pty Ltd, Sydney, New South Wales, Australia.
FAU - Bell, Richard
AU  - Bell R
AD  - Deakin University, Warun Ponds, Victoria, Australia.
FAU - Woodward, Natasha
AU  - Woodward N
AD  - Mater Health Services/Mater Research Institute, South Brisbane, Queensland, 
      Australia.
FAU - McCarthy, Nicole
AU  - McCarthy N
AD  - Wesley Medical Centre and University of Queensland, Queensland, Australia.
FAU - De Boer, Richard
AU  - De Boer R
AD  - Royal Melbourne Hospital, Parkville, Victoria, Australia.
FAU - Loi, Sherene
AU  - Loi S
AD  - Peter MacCallum Cancer Centre, Victoria, Australia.
FAU - Redfern, Andrew
AU  - Redfern A
AD  - Fiona Stanley Hospital, Perth, Western Australia, Australia.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
PL  - Australia
TA  - Asia Pac J Clin Oncol
JT  - Asia-Pacific journal of clinical oncology
JID - 101241430
RN  - 0 (Receptors, Estrogen)
RN  - 0 (Receptors, Progesterone)
RN  - EC 2.7.10.1 (Receptor, ErbB-2)
SB  - IM
MH  - Breast Neoplasms/*metabolism/*therapy
MH  - Clinical Trials as Topic
MH  - Combined Modality Therapy
MH  - Female
MH  - Humans
MH  - Meta-Analysis as Topic
MH  - Prognosis
MH  - Receptor, ErbB-2/*metabolism
MH  - Receptors, Estrogen/*metabolism
MH  - Receptors, Progesterone/*metabolism
OTO - NOTNLM
OT  - breast cancer
OT  - disease-free survival
OT  - hormone receptor positive
OT  - metastatic
OT  - systematic review
EDAT- 2016/03/24 06:00
MHDA- 2016/10/26 06:00
CRDT- 2016/03/23 06:00
PHST- 2016/03/01 00:00 [accepted]
PHST- 2016/03/23 06:00 [entrez]
PHST- 2016/03/24 06:00 [pubmed]
PHST- 2016/10/26 06:00 [medline]
AID - 10.1111/ajco.12491 [doi]
PST - ppublish
SO  - Asia Pac J Clin Oncol. 2016 Mar;12 Suppl 1:3-18. doi: 10.1111/ajco.12491.