Evidence map›Paper›PMID 36539670›Full record

ArticleBreast cancer research and treatment2023

Effect of prior treatments on post-CDK 4/6 inhibitor survival in hormone receptor-positive breast cancer.

Jeffrey Franks, Nicole E Caston, Ahmed Elkhanany, Travis Gerke, Andres Azuero, Gabrielle B Rocque

Open access · hybridAbstract read
In one paragraph

Article in Breast cancer research and treatment, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Observational
  3. Article
  4. Observational
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Jeffrey FranksDepartment of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, 1808 7th Avenue South 35233 - Boshell Diabetes Building, Birmingham, AL, USA.
Nicole E CastonDepartment of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, 1808 7th Avenue South 35233 - Boshell Diabetes Building, Birmingham, AL, USA.
Ahmed ElkhananyDepartment of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, 1808 7th Avenue South 35233 - Boshell Diabetes Building, Birmingham, AL, USA.
Travis GerkeThe Prostate Cancer Clinical Trials Consortium, New York, NY, USA.
Andres AzueroO'Neal Comprehensive Cancer Center, Birmingham, AL, USA.
Gabrielle B RocqueDepartment of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, 1808 7th Avenue South 35233 - Boshell Diabetes Building, Birmingham, AL, USA. grocque@uabmc.edu.ORCID http://orcid.org/0000-0003-4188-9785
University of Alabama at Birmingham · USCancer Clinic · US

Funding

Pfizer 5552703
6 · The paper itself

Abstract

purposeMultiple treatment options exist for patients with metastatic breast cancer (MBC). However, limited information is available on the impact of prior treatment duration and class on survival outcome for novel therapies, such as cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) for patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+ HER2-) MBC.

methodsThis study used a nationwide, de-identified electronic health record-derived database to identify women with HR+ HER2- MBC who received at least one CDK 4/6i between 2011 and 2020. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated for the association between prior duration and class of cancer treatment (both early-stage and metastatic) and prior CDK 4/6i survival as well as for those with multiple CDK 4/6i.

resultsOf 5363 patients, the median survival from first CDK 4/6 inhibitor administration was 3.3 years. When compared to patients with no prior treatments, patients with < 1 year of prior treatment duration had a 30% increased hazard of death (HR, 1.30; 95% CI 1.15-1.46), those with 1 to < 3 years a 68% increased hazard of death (HR 1.68; 95% CI 1.49-1.88), and those with 3 or more years a 55% increased hazard of death (HR 1.55; 95% CI 1.36, 1.76). Patients who received prior therapy (endocrine or chemotherapy) before their CDK 4/6i had worse outcomes than those who received no prior therapy. Similar results were seen when comparing patients in the metastatic setting alone. Finally, patients who received a different CDK 4/6i after their first saw a lower hazard of death compared to patients who received subsequent endocrine or chemotherapy after their first CDK 4/6i.

conclusionPrior treatment duration and class are associated with a decreased overall survival after CDK 4/6 inhibitor administration. This highlights the importance for clinicians to consider prior treatment and duration in treatment decision-making and for trialists to stratify by these factors when randomizing patients or reporting results of future studies.

Indexed as

Breast NeoplasmsErb-b2 Receptor Tyrosine KinasesAntineoplastic Combined Chemotherapy ProtocolsCyclin-Dependent Kinase 4Cyclin-Dependent Kinase 6FemaleHumansProtein Kinase InhibitorsCDK4 protein, humanCDK6 protein, humanCyclin-Dependent Kinase 4Cyclin-Dependent Kinase 6Erb-b2 Receptor Tyrosine KinasesProtein Kinase InhibitorsCyclin-dependent kinase 4/6 inhibitorsDurationVisualization

Identifiers

PMID36539670
PMCPMC9883320
OpenAlexW4312066888

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.