Evidence map›Paper›PMID 40392524›Full record

Observational studyBreast cancer (Tokyo, Japan)2025

Real-world evidence from Japan regarding survival outcomes and treatment sequence in patients receiving CDK4/6 inhibitor plus endocrine therapy as first- or second-line treatment for hormone receptor-positive, HER2-negative advanced or metastatic breast cancer.

Tetsuhiro Yoshinami, Yuko Takano, Yukinori Ozaki, Yukiko Kajiwara, Mitsugu Yamamoto, Ken-Ichi Watanabe, Masami Tsukabe, Fumie Fujisawa, Shigenori E Nagai, Nobuhiro Shibata and 13 more

Erratum issuedAbstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Breast cancer (Tokyo, Japan), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors.

Tetsuhiro YoshinamiDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, 2-2-E10 Yamadaoka, Suita, Osaka, 565-0871, Japan. yosinami-te@onsurg.med.osaka-u.ac.jp.ORCID http://orcid.org/0009-0000-8747-3641
Yuko TakanoDepartment of Breast and Endocrine Surgery, Nagoya University Hospital, Nagoya, Aichi, Japan.ORCID http://orcid.org/0000-0002-3753-7683
Yukinori OzakiDepartment of Breast Medical Oncology, The Cancer Institute Hospital of JFCR, Tokyo, Japan.
Yukiko KajiwaraDepartment of Breast Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.
Mitsugu YamamotoDepartment of Breast Oncology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Hokkaido, Japan.
Ken-Ichi WatanabeDepartment of Breast Oncology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Hokkaido, Japan.
Masami TsukabeDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, 2-2-E10 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Fumie FujisawaDepartment of Medical Oncology, Shiga General Hospital, Moriyama, Shiga, Japan.
Shigenori E NagaiDivision of Breast Oncology, Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan.
Nobuhiro ShibataDepartment of Clinical Oncology, Kansai Medical University Hospital, Hirakata, Osaka, Japan.ORCID http://orcid.org/0000-0001-8647-5098
Chiya OshiroDepartment of Breast Surgery, Kaizuka City Hospital, Kaizuka, Osaka, Japan.
Hiroko BandoDepartment of Breast and Endocrine Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Nobuyuki TsunodaDepartment of Breast Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Aichi, Japan.ORCID http://orcid.org/0000-0002-4993-0028
Kazuhiko YamagamiDepartment of Breast Surgery and Oncology, Shinko Hospital, Kobe, Hyogo, Japan.
Kei KoizumiDepartment of Surgery 1, Division of Breast Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
Masahiro TakadaDepartment of Breast Surgery, Kansai Medical University, Hirakata, Osaka, Japan.ORCID http://orcid.org/0000-0002-5954-1296
Naoko ToriguchiDepartment of Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K, Kobe, Hyogo, Japan.
Nobuyuki SekineDepartment of Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K, Kobe, Hyogo, Japan.
Tsutomu KawaguchiDepartment of Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K, Kobe, Hyogo, Japan.
Shigehira SajiDepartment of Medical Oncology, Fukushima Medical University, Fukushima, Japan.ORCID http://orcid.org/0000-0002-6732-8030
Yasuaki SagaraDepartment of Breast and Thyroid Surgical Oncology, Social Medical Corporation Hakuaikai Sagara Hospital, Kagoshima, Japan.
Satoshi MoritaDepartment of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.ORCID http://orcid.org/0000-0002-4344-3317
Norikazu MasudaDepartment of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.ORCID http://orcid.org/0000-0002-7302-0278

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) plus endocrine therapy (ET) is a current standard first-/second-line treatment for hormone receptor (HR)-positive, HER2-negative advanced/metastatic breast cancer (AMBC). We aimed to provide real-world evidence regarding CDK4/6i therapy in this population.

methodsIn this multicenter observational study, data from patients who had started CDK4/6i therapy between January 1, 2019, and December 31, 2021, as first-/second-line treatment for AMBC were used; real-world progression-free survival (rwPFS), chemotherapy-free survival, and overall survival were analyzed using the Kaplan-Meier method. Additionally, data were analyzed by separating patients with treatment-free interval (TFI) < 12 months (deemed resistant to ET) from the first-line treatment group (hereafter, the exclusive first-line treatment group).

resultsData from 745 patients were analyzed. Compared with palbociclib, abemaciclib was used in younger patients and those with expected poor prognosis. Median rwPFS was 36.8, 17.8, and 31.4 months in patients with de novo stage IV disease, TFI < 12 months, and TFI ≥ 12 months, respectively, in the first-line treatment group, and 17.4 months in the second-line treatment group. In the exclusive first-line treatment group, median rwPFS of the subsequent treatment after initial CDK4/6i plus ET was < 7 months, regardless of the type of subsequent treatment; prognosis was especially poor in those who were switched to chemotherapy.

conclusionsThe real-world survival outcomes found in this study for patients receiving first-/second-line CDK4/6i therapy were consistent with those of randomized phase 3 studies. As outcomes of subsequent treatment after initial CDK4/6i plus ET remain insufficient, further improvement in treatment is necessary.

Indexed as

Antineoplastic Agents, HormonalAntineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsCyclin-Dependent Kinase 4Protein Kinase InhibitorsAdultAgedAged, 80 and overAminopyridinesBenzimidazolesCyclin-Dependent Kinase 6Erb-b2 Receptor Tyrosine KinasesFemaleHumansJapanMiddle AgedabemaciclibAminopyridinesAntineoplastic Agents, HormonalBenzimidazolesCDK4 protein, humanCDK6 protein, humanCyclin-Dependent Kinase 4Cyclin-Dependent Kinase 6ERBB2 protein, humanErb-b2 Receptor Tyrosine KinasespalbociclibPiperazinesProtein Kinase InhibitorsPyridinesReceptors, EstrogenReceptors, ProgesteroneAbemaciclibAdvanced or metastatic breast cancerCyclin-dependent kinase 4/6 inhibitorPalbociclibReal-world evidence

Identifiers

PMID40392524
PMCPMC12174191

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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.