Safety of cyclin-dependent kinase4/6 inhibitor combined with palliative radiotherapy in patients with metastatic breast cancer
Introduction: Cyclin-dependent kinase (CDK)4/6 inhibitor is a first-line therapy for metastatic ER+/HER2-breast cancer. However, there are limited data on safety of combined radiotherapy (RT) and CDK4/6 inhibition. Methods: We conducted a retrospective study of women with metastatic breast cancer wh...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-12-01
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| Series: | Breast |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0960977621004719 |
| _version_ | 1818979245361201152 |
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| author | Kristine N. Kim Payal Shah Amy Clark Gary M. Freedman Sana Dastgheyb Andrew R. Barsky Alexandra D. Dreyfuss Neil K. Taunk |
| author_facet | Kristine N. Kim Payal Shah Amy Clark Gary M. Freedman Sana Dastgheyb Andrew R. Barsky Alexandra D. Dreyfuss Neil K. Taunk |
| author_sort | Kristine N. Kim |
| collection | DOAJ |
| description | Introduction: Cyclin-dependent kinase (CDK)4/6 inhibitor is a first-line therapy for metastatic ER+/HER2-breast cancer. However, there are limited data on safety of combined radiotherapy (RT) and CDK4/6 inhibition. Methods: We conducted a retrospective study of women with metastatic breast cancer who received palliative RT within 14 days of CDK4/6 inhibitor use. The primary endpoint was toxicity per Common Terminology Criteria for Adverse Events v5. Secondary endpoints were pain response and local control based on clinical assessment and imaging. Results: Thirty patients underwent 36 RT courses with palbociclib (n = 34 courses, 94.4%) or abemaciclib (n = 2, 5.6%). RT was delivered before, concurrently or after CDK4/6 inhibitors in 7 (19.4%), 8 (22.2%), and 21 (58.3%) of cases with median 3.5 days from RT to closest CDK4/6 inhibitor administration. Median RT dose was 30Gy (range 8–40.05Gy). Treated sites included brain (n = 5, 11.6%), spine (n = 19, 44.2%), pelvis (n = 9, 20.9%), other bony sites (n = 6, 14.0%) and others (n = 4, 9.3%). No acute grade ≥3 non-hematologic toxicity occurred. No increased hematologic toxicity was attributable to RT with grade 3 hematologic toxicities rates 16.7%, 0%, and 6.7% before, during, and 2 weeks after RT completion. All but one patient (29/30) achieved symptom relief. Local control rates were 94.4%, 91.7% at 6 and 12 months. Conclusions: The use of RT within 2 weeks of CDK4/6 inhibitors had low acceptable toxicity and high efficacy, suggesting that it is safe for palliation of metastatic breast cancer. |
| first_indexed | 2024-12-20T16:56:28Z |
| format | Article |
| id | doaj.art-95dee8fe36ad40bb92e7e37f5c8be25f |
| institution | Directory Open Access Journal |
| issn | 1532-3080 |
| language | English |
| last_indexed | 2024-12-20T16:56:28Z |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Breast |
| spelling | doaj.art-95dee8fe36ad40bb92e7e37f5c8be25f2022-12-21T19:32:43ZengElsevierBreast1532-30802021-12-0160163167Safety of cyclin-dependent kinase4/6 inhibitor combined with palliative radiotherapy in patients with metastatic breast cancerKristine N. Kim0Payal Shah1Amy Clark2Gary M. Freedman3Sana Dastgheyb4Andrew R. Barsky5Alexandra D. Dreyfuss6Neil K. Taunk7Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USADepartment of Medicine, Division of Hematology Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USADepartment of Medicine, Division of Hematology Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USADepartment of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USADepartment of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USADepartment of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USADepartment of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USADepartment of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Corresponding author. Radiation Oncology, University of Pennsylvania, Perelman Center for Advanced Medicine, 3400 Civic Center Boulevard, TRC4-347W, Philadelphia, PA 19104, USA.Introduction: Cyclin-dependent kinase (CDK)4/6 inhibitor is a first-line therapy for metastatic ER+/HER2-breast cancer. However, there are limited data on safety of combined radiotherapy (RT) and CDK4/6 inhibition. Methods: We conducted a retrospective study of women with metastatic breast cancer who received palliative RT within 14 days of CDK4/6 inhibitor use. The primary endpoint was toxicity per Common Terminology Criteria for Adverse Events v5. Secondary endpoints were pain response and local control based on clinical assessment and imaging. Results: Thirty patients underwent 36 RT courses with palbociclib (n = 34 courses, 94.4%) or abemaciclib (n = 2, 5.6%). RT was delivered before, concurrently or after CDK4/6 inhibitors in 7 (19.4%), 8 (22.2%), and 21 (58.3%) of cases with median 3.5 days from RT to closest CDK4/6 inhibitor administration. Median RT dose was 30Gy (range 8–40.05Gy). Treated sites included brain (n = 5, 11.6%), spine (n = 19, 44.2%), pelvis (n = 9, 20.9%), other bony sites (n = 6, 14.0%) and others (n = 4, 9.3%). No acute grade ≥3 non-hematologic toxicity occurred. No increased hematologic toxicity was attributable to RT with grade 3 hematologic toxicities rates 16.7%, 0%, and 6.7% before, during, and 2 weeks after RT completion. All but one patient (29/30) achieved symptom relief. Local control rates were 94.4%, 91.7% at 6 and 12 months. Conclusions: The use of RT within 2 weeks of CDK4/6 inhibitors had low acceptable toxicity and high efficacy, suggesting that it is safe for palliation of metastatic breast cancer.http://www.sciencedirect.com/science/article/pii/S0960977621004719CDK4/6 inhibitorRadiotherapyPalliationMetastatic breast cancerSafety |
| spellingShingle | Kristine N. Kim Payal Shah Amy Clark Gary M. Freedman Sana Dastgheyb Andrew R. Barsky Alexandra D. Dreyfuss Neil K. Taunk Safety of cyclin-dependent kinase4/6 inhibitor combined with palliative radiotherapy in patients with metastatic breast cancer Breast CDK4/6 inhibitor Radiotherapy Palliation Metastatic breast cancer Safety |
| title | Safety of cyclin-dependent kinase4/6 inhibitor combined with palliative radiotherapy in patients with metastatic breast cancer |
| title_full | Safety of cyclin-dependent kinase4/6 inhibitor combined with palliative radiotherapy in patients with metastatic breast cancer |
| title_fullStr | Safety of cyclin-dependent kinase4/6 inhibitor combined with palliative radiotherapy in patients with metastatic breast cancer |
| title_full_unstemmed | Safety of cyclin-dependent kinase4/6 inhibitor combined with palliative radiotherapy in patients with metastatic breast cancer |
| title_short | Safety of cyclin-dependent kinase4/6 inhibitor combined with palliative radiotherapy in patients with metastatic breast cancer |
| title_sort | safety of cyclin dependent kinase4 6 inhibitor combined with palliative radiotherapy in patients with metastatic breast cancer |
| topic | CDK4/6 inhibitor Radiotherapy Palliation Metastatic breast cancer Safety |
| url | http://www.sciencedirect.com/science/article/pii/S0960977621004719 |
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