Evidence map›Paper›PMID 39169295›Full record

SynthesisBMC cancer2024

CDK4/6 inhibitors plus endocrine therapy vs. placebo plus endocrine therapy for HR+/HER2- advanced breast cancer: a phase III RCTs based meta-analysis.

Cailu Luo, Kunlin Yu, Xiaodan Luo, Tao Lian, Xuejuan Liu, Wang Xu, Zhongkui Jin

Abstract readComparative StudyMeta-Analysis
In one paragraph

Synthesis in BMC cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. 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

7 authors.

Cailu LuoDepartment of General Surgery, Yichun People's Hospital, No. 1061 Jinxiu Avenue, Yiyang New District, Yichun, jiangxi, 336000, China.
Kunlin YuDepartment of General Surgery, Yichun People's Hospital, No. 1061 Jinxiu Avenue, Yiyang New District, Yichun, jiangxi, 336000, China.
Xiaodan LuoDepartment of General Surgery, Yichun People's Hospital, No. 1061 Jinxiu Avenue, Yiyang New District, Yichun, jiangxi, 336000, China.
Tao LianDepartment of General Surgery, Yichun People's Hospital, No. 1061 Jinxiu Avenue, Yiyang New District, Yichun, jiangxi, 336000, China.
Xuejuan LiuDepartment of General Surgery, Yichun People's Hospital, No. 1061 Jinxiu Avenue, Yiyang New District, Yichun, jiangxi, 336000, China.
Wang XuDepartment of General Surgery, Yichun People's Hospital, No. 1061 Jinxiu Avenue, Yiyang New District, Yichun, jiangxi, 336000, China.
Zhongkui JinDepartment of General Surgery, Yichun People's Hospital, No. 1061 Jinxiu Avenue, Yiyang New District, Yichun, jiangxi, 336000, China. jinzk1975@163.com.

Funding

Natural Science Foundation of Jiangxi Province 20212BAB206050
6 · The paper itself

Abstract

backgroundDoes incorporating Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors into endocrine therapy (ET) effectively enhance survival outcomes, notably overall survival (OS), among individuals with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer? This remains a clinical controversy. We compared the antitumor efficacy and adverse effects (AEs) between CDK4/6 inhibitors + ET (CET) and placebo + ET (PET) by conducting a phase III randomized controlled trials (RCTs) based meta-analysis.

methodsSeven databases were searched to identify eligible studies, comprising Phase III RCTs comparing CET to PET. The primary endpoints were OS and progression-free survival (PFS), with secondary endpoints including responses and adverse events (AEs).

resultsSeven RCTs (DAWNA-2, MONALEESA-2, MONALEESA-3, MONALEESA-7, MONARCH-3, PALOMA-2, and PALOMA-4) were included. The CET group exhibited significantly improved OS (HR: 0.81 [0.74, 0.88]), PFS (HR: 0.57 [0.52, 0.63]), objective response rate (RR: 1.31 [1.20, 1.43]), and clinical benefit rate (RR: 1.11 [1.07, 1.15]). These benefits were consistent across almost all subgroups. Additionally, the CET group showed better overall survival rates (OSR) from 24 to 60 months (OSR 24-60 m) and progression-free survival rates (PFSR) from 6 to 60 months (PFSR 6-60 m). However, more total AEs, grade 3-5 AEs, and serious AEs were found in CET group. The top 5 grade 3-5 AEs in the CET group were neutropenia (59.39%), leukopenia (24.11%), decreased white blood cell count (12.99%), hypertension (7.03%), and increased alanine aminotransferase (5.91%).

conclusionsThe superiority of CET over PET in HR+/HER2- advanced breast cancer is evident, showing improved survival and responses. Nonetheless, the higher incidence of AEs, specifically hematologic AEs, requires cautious attention.

Indexed as

Antineoplastic Agents, HormonalAntineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsCyclin-Dependent Kinase 4Cyclin-Dependent Kinase 6Erb-b2 Receptor Tyrosine KinasesProtein Kinase InhibitorsClinical Trials, Phase III as TopicFemaleHumansProgression-Free SurvivalRandomized Controlled Trials as TopicReceptors, EstrogenReceptors, ProgesteroneAntineoplastic Agents, HormonalCDK4 protein, humanCDK6 protein, humanCyclin-Dependent Kinase 4Cyclin-Dependent Kinase 6ERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesProtein Kinase InhibitorsReceptors, EstrogenReceptors, ProgesteroneBreast CancerCDK4/6 inhibitorsEndocrine therapyMeta-analysisRandomized controlled trials

Identifiers

PMID39169295
PMCPMC11337580

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.