SynthesisJNCI cancer spectrum2024
QTc prolongation across CDK4/6 inhibitors: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in JNCI cancer spectrum, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- MicroRNAs and Alarmins in Cardio-Oncology: Biomarkers and Therapeutic Implications in Skin and Breast Cancer.International journal of molecular sciences · 2026Review
- Cardiovascular event burden in women with breast cancer treated with CDK4/6 inhibitors: a retrospective matched cohort study.Cardio-oncology (London, England) · 2026Article
- QT Prolongation and Arrhythmias in Cancer Therapy: A Narrative Review of Mechanistic and Clinical Studies.Cardiovascular toxicology · 2026Review
- The mechanisms and therapeutic advances of interactions between breast cancer and cardiovascular diseases.Frontiers in pharmacology · 2026Review
- Integration of pre‑existing cardiovascular comorbidity into CDK4/6 inhibitor selection for breast cancer.Therapeutic advances in drug safety · 2026Article
- Distinct renal adverse event profiles among CDK4/6 inhibitors: a comparative pharmacovigilance analysis.Frontiers in pharmacology · 2026Article
- Real-World Effectiveness and Safety of Ribociclib Plus Aromatase Inhibitors in Patients with HR+/HER2- Metastatic Breast Cancer: A Multicenter Experience from Vietnam.Asian Pacific journal of cancer prevention : APJCP · 2025Article
- Applications, challenges and future directions of artificial intelligence in cardio-oncology.European journal of clinical investigation · 2025Review
- Emerging cardiovascular toxicity associated with CDK4/6 inhibitors: real-world insights from the FDA adverse event reporting system.Frontiers in pharmacology · 2025Article
- Breast cancer in a transgender man.CA: a cancer journal for cliniciansArticle
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCyclin-dependent kinases (CDK) 4/6 inhibitors have significantly improved outcomes for patients with ER+/HER2- breast cancer. Nevertheless, they differ from each other in terms of chemical, biological, and pharmacological features, as well as toxicity profiles. We aim to determine whether QTc prolongation is caused by CDK4/6i in general or if it is associated with ribociclib only.
methodsWe systematically searched PubMed, Embase, and Cochrane Library for randomized controlled trials (RCTs) comparing the prevalence of QTc prolongation as an adverse event in HR+ breast cancer patients treated with CDK4/6i vs those without CDK4/6i. We pooled relative risk (RR) and mean difference (MD) with 95% confidence interval (CI) for the binary endpoint of QT prolongation.
resultsWe included 14 RCTs comprising 16 196 patients, of whom 8576 underwent therapy with CDK4/6i. An increased risk of QTc prolongation was associated with the use of CDK4/6i (RR = 2.35, 95% CI = 1.67 to 3.29, P < .001; I2 = 44%). Subgroup analyses revealed a significant increase in the QTc interval for the ribociclib and palbociclib cohorts. The ribociclib subgroup showed a relative risk of 3.12 (95% CI = 2.09 to 4.65, P < .001; I2 = 12%), whereas the palbociclib subgroup had a relative risk of 1.51 (95% CI = 1.05 to 2.15, P = .025; I2 = 0%).
conclusionPalbociclib was associated with QTc prolongation; however, the relative risk for any grade QTc was quantitively twice with ribociclib. Furthermore, grade 3 QTc prolongations were observed exclusively with ribociclib. These results are important for guiding clinical decision-making and provide reassurance regarding the overall safety profile of this drug class.
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