PMID- 36349599
OWN - NLM
STAT- MEDLINE
DCOM- 20221220
LR  - 20230212
IS  - 1879-0887 (Electronic)
IS  - 0167-8140 (Linking)
VI  - 177
DP  - 2022 Dec
TI  - Safety of CDK4/6 inhibitors and concomitant radiation therapy in patients 
      affected by metastatic breast cancer.
PG  - 40-45
LID - S0167-8140(22)04518-2 [pii]
LID - 10.1016/j.radonc.2022.10.023 [doi]
AB  - PURPOSE: Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) currently represent the 
      standard of care for the initial treatment of patients with metastatic hormone 
      receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) 
      breast cancer. The aim of our study is to evaluate the safety of the use of 
      concomitant radiation therapy (RT) in a consecutive series of HR+/HER2- patients 
      treated in two academic institutions with CDK4/6i in the metastatic setting. 
      METHODS AND MATERIALS: From September 2017 to February 2020, we retrospectively 
      collected and analysed data on a sequential series of patients treated with 
      CDK4/6i, receiving RT or not, at two European institutions. Primary outcome of 
      the study was the association between RT and any adverse events (AEs) >/= G3. 
      Secondary outcomes were the association between RT and any AEs (any grade), 
      CDK4/6i dose reduction rate, and CDK4/6i treatment discontinuation rate. RESULTS: 
      We analysed a total of 132 consecutive women; RT was prescribed in 57 (43.2%) 
      patients (70 irradiated lesions). The median age of the series was 52.1 years 
      (range 32.3-78.2). Concomitant RT administration was not significantly related to 
      higher AEs >/= G3 (p = 0.19) and any grade AEs (p = 1.0); there was no association 
      with RT and CDK4/6i dose reduction (p = 0.49) and discontinuation rates 
      (p = 0.14). At a median follow-up of 18.8 months, the progression-free survival 
      (PFS) rate was 35% and the overall survival (OS) rate was 38.7% in the whole 
      group. The use of concomitant RT did not affect both PFS (p = 0.71) and OS rates 
      (p = 0.55). CONCLUSIONS: Our data are encouraging regarding the safety of this 
      combination, showing that concurrent RT did not increase severe toxicity and did 
      not have an impact on systemic treatment conduction.
CI  - Copyright (c) 2022 Elsevier B.V. All rights reserved.
FAU - Visani, Luca
AU  - Visani L
AD  - Department of Experimental and Clinical Biomedical Sciences "M. Serio", 
      University of Florence, Florence, Italy.
FAU - Livi, Lorenzo
AU  - Livi L
AD  - Department of Experimental and Clinical Biomedical Sciences "M. Serio", 
      University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology 
      Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
FAU - Ratosa, Ivica
AU  - Ratosa I
AD  - Division of Radiation Oncology, Institute of Oncology Ljubljana, Ljubljana, 
      Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
FAU - Orazem, Miha
AU  - Orazem M
AD  - Division of Radiation Oncology, Institute of Oncology Ljubljana, Ljubljana, 
      Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
FAU - Ribnikar, Domen
AU  - Ribnikar D
AD  - Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; Division of 
      Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
FAU - Saieva, Calogero
AU  - Saieva C
AD  - Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer 
      Research Prevention and Clinical Network, Florence, Italy.
FAU - Becherini, Carlotta
AU  - Becherini C
AD  - Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria 
      Careggi, Florence, Italy.
FAU - Salvestrini, Viola
AU  - Salvestrini V
AD  - Department of Experimental and Clinical Biomedical Sciences "M. Serio", 
      University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology 
      Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
FAU - Scoccimarro, Erika
AU  - Scoccimarro E
AD  - Department of Experimental and Clinical Biomedical Sciences "M. Serio", 
      University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology 
      Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
FAU - Valzano, Marianna
AU  - Valzano M
AD  - Department of Experimental and Clinical Biomedical Sciences "M. Serio", 
      University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology 
      Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
FAU - Cerbai, Cecilia
AU  - Cerbai C
AD  - Department of Experimental and Clinical Biomedical Sciences "M. Serio", 
      University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology 
      Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
FAU - Desideri, Isacco
AU  - Desideri I
AD  - Department of Experimental and Clinical Biomedical Sciences "M. Serio", 
      University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology 
      Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
FAU - Bernini, Marco
AU  - Bernini M
AD  - Breast Surgery Unit, Careggi University Hospital, Florence, Italy.
FAU - Orzalesi, Lorenzo
AU  - Orzalesi L
AD  - Breast Surgery Unit, Careggi University Hospital, Florence, Italy.
FAU - Nori, Jacopo
AU  - Nori J
AD  - Diagnostic Senology Unit, Careggi University Hospital, Florence, Italy.
FAU - Bianchi, Simonetta
AU  - Bianchi S
AD  - Division of Pathological Anatomy, Department of Health Sciences, University of 
      Florence, Florence, Italy.
FAU - Morandi, Andrea
AU  - Morandi A
AD  - Department of Experimental and Clinical Biomedical Sciences "M. Serio", 
      University of Florence, Florence, Italy.
FAU - Meattini, Icro
AU  - Meattini I
AD  - Department of Experimental and Clinical Biomedical Sciences "M. Serio", 
      University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology 
      Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. 
      Electronic address: icro.meattini@unifi.it.
LA  - eng
PT  - Journal Article
DEP - 20221028
PL  - Ireland
TA  - Radiother Oncol
JT  - Radiotherapy and oncology : journal of the European Society for Therapeutic 
      Radiology and Oncology
JID - 8407192
RN  - EC 2.7.11.22 (Cyclin-Dependent Kinase 6)
RN  - EC 2.7.11.22 (Cyclin-Dependent Kinase 4)
RN  - 0 (Receptors, Progesterone)
RN  - 0 (Receptors, Estrogen)
RN  - 0 (Protein Kinase Inhibitors)
RN  - EC 2.7.11.22 (CDK4 protein, human)
SB  - IM
MH  - Humans
MH  - Female
MH  - Adult
MH  - Middle Aged
MH  - Aged
MH  - *Breast Neoplasms/drug therapy/radiotherapy
MH  - Cyclin-Dependent Kinase 6/metabolism/therapeutic use
MH  - Cyclin-Dependent Kinase 4/metabolism/therapeutic use
MH  - Receptors, Progesterone/metabolism
MH  - Receptors, Estrogen/metabolism
MH  - Retrospective Studies
MH  - Protein Kinase Inhibitors/adverse effects
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
OTO - NOTNLM
OT  - Breast cancer
OT  - CDK4/6 inhibitors
OT  - Concomitant treatment
OT  - Oligometastatic disease
OT  - Radiotherapy
EDAT- 2022/11/10 06:00
MHDA- 2022/12/21 06:00
CRDT- 2022/11/09 04:09
PHST- 2022/03/20 00:00 [received]
PHST- 2022/10/12 00:00 [revised]
PHST- 2022/10/20 00:00 [accepted]
PHST- 2022/11/10 06:00 [pubmed]
PHST- 2022/12/21 06:00 [medline]
PHST- 2022/11/09 04:09 [entrez]
AID - S0167-8140(22)04518-2 [pii]
AID - 10.1016/j.radonc.2022.10.023 [doi]
PST - ppublish
SO  - Radiother Oncol. 2022 Dec;177:40-45. doi: 10.1016/j.radonc.2022.10.023. Epub 2022 
      Oct 28.