PMID- 29804650
OWN - NLM
STAT- MEDLINE
DCOM- 20190919
LR  - 20190919
IS  - 1938-0666 (Electronic)
IS  - 1526-8209 (Linking)
VI  - 18
IP  - 5
DP  - 2018 Oct
TI  - CDK4/6 Inhibitors in Combination With Hormone Therapy for HR(+)/HER2(-) Advanced 
      Breast Cancer: A Systematic Review and Meta-analysis of Randomized Controlled 
      Trials.
PG  - e943-e953
LID - S1526-8209(17)30798-X [pii]
LID - 10.1016/j.clbc.2018.04.017 [doi]
AB  - BACKGROUND: This meta-analysis of randomized controlled trials aimed to 
      comprehensively assess the efficacy and toxicity of cyclin-dependent kinase (CDK) 
      4/6 inhibitors in advanced breast cancer (ABC) with hormone-receptor positive 
      (HR(+)) and human epidermal growth factor receptor 2 negative (HER2(-)) disease. 
      METHODS: We performed a systematical search using Cochrane Library, PubMed, 
      Embase, and Web of Science up to March 2018. Only phase 2 and 3 randomized 
      clinical trials assessing the efficacy and toxicity of the combination regimen of 
      CDK4/6 inhibitors plus hormone therapy compared with hormone therapy alone were 
      eligible for this meta-analysis. The pooled analyses of relative risk (RR) and 
      hazard ratio were carried out by Stata software. RESULTS: A total of 7 randomized 
      controlled trials including 3854 patients with HR(+)/HER2(-) ABC were included in 
      this meta-analysis. The pooled hazard ratio for progression-free survival was 
      0.54 (95% confidence interval, 0.49-0.59; P < .001), and the pooled RR for the 
      objective response rate in all intent-to-treat patients was 1.51 (95% confidence 
      interval, 1.26-1.81; P < .001). The pooled RRs for all grade adverse events (AEs) 
      and grade 3/4 AEs were 1.07 (95% confidence interval, 1.03-1.11; P < .001) and 
      2.81 (95% confidence interval, 2.54-3.11; P < .001), respectively. However, to 
      investigate the influence of CDK4/6 inhibitors on overall survival, sufficient 
      follow-up is still needed. CONCLUSION: CDK4/6 inhibitors plus hormone therapy can 
      significantly prolong the progression-free survival of patients with 
      HR(+)/HER2(-) ABC and improve the objective response rate compared to 
      conventional hormone therapy alone. The combined regimen results in a higher risk 
      of AEs, especially grade 3/4 AEs.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Deng, Yunfu
AU  - Deng Y
AD  - Cancer Center, Sichuan University, Chengdu, China.
FAU - Ma, Guangzhi
AU  - Ma G
AD  - Department of Thoracic Surgery, Sichuan University, Chengdu, China.
FAU - Li, Wen
AU  - Li W
AD  - Cancer Center, Sichuan University, Chengdu, China.
FAU - Wang, Ting
AU  - Wang T
AD  - Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
FAU - Zhao, Yaqin
AU  - Zhao Y
AD  - Cancer Center, Sichuan University, Chengdu, China.
FAU - Wu, Qiang
AU  - Wu Q
AD  - Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, China. 
      Electronic address: wuqiang818@126.com.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20180504
PL  - United States
TA  - Clin Breast Cancer
JT  - Clinical breast cancer
JID - 100898731
RN  - 0 (Antineoplastic Agents, Hormonal)
RN  - 0 (Protein Kinase Inhibitors)
RN  - 0 (Receptors, Estrogen)
RN  - 0 (Receptors, Progesterone)
RN  - EC 2.7.10.1 (Receptor, ErbB-2)
RN  - EC 2.7.11.22 (Cyclin-Dependent Kinase 4)
RN  - EC 2.7.11.22 (Cyclin-Dependent Kinase 6)
SB  - IM
MH  - Antineoplastic Agents, Hormonal/therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - Breast Neoplasms/*drug therapy/metabolism/pathology
MH  - Cyclin-Dependent Kinase 4/*antagonists & inhibitors
MH  - Cyclin-Dependent Kinase 6/*antagonists & inhibitors
MH  - Disease-Free Survival
MH  - Drug-Related Side Effects and Adverse Reactions
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Odds Ratio
MH  - Protein Kinase Inhibitors/adverse effects/*therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - Receptor, ErbB-2/metabolism
MH  - Receptors, Estrogen/metabolism
MH  - Receptors, Progesterone/metabolism
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Cohort studies
OT  - Hazard ratio
OT  - Meta-regression analysis
OT  - Prognosis
OT  - Relative risk
EDAT- 2018/05/29 06:00
MHDA- 2019/09/20 06:00
CRDT- 2018/05/29 06:00
PHST- 2017/12/12 00:00 [received]
PHST- 2018/03/30 00:00 [revised]
PHST- 2018/04/23 00:00 [accepted]
PHST- 2018/05/29 06:00 [pubmed]
PHST- 2019/09/20 06:00 [medline]
PHST- 2018/05/29 06:00 [entrez]
AID - S1526-8209(17)30798-X [pii]
AID - 10.1016/j.clbc.2018.04.017 [doi]
PST - ppublish
SO  - Clin Breast Cancer. 2018 Oct;18(5):e943-e953. doi: 10.1016/j.clbc.2018.04.017. 
      Epub 2018 May 4.