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CDK4/6 inhibitor selection in metastatic breast cancer

CDK4/6 inhibitors in mBC

Cyclin dependent kinase 4/6 (CDK4/6) inhibitors now represent a standard of care for HR+/HER2- metastatic breast cancer. Find out more on the mode of action, clinical trial outcomes and the latest overall survival data for the three CDK4/6 inhibitors; abemaciclib, palbociclib and ribociclib.

Breast cancer accounts for almost one-quarter of all cancer cases in women worldwide. In 2018 alone, there were an estimated 2.1 million new cases1, with over 520,000 of these reported in European countries2

Roughly one third of patients diagnosed with breast cancer will go on to develop metastatic breast cancer (mBC) and 6% will have an initial diagnosis of, or de novo, mBC3.

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Given the heterogeneity of breast cancer, personalisation of treatment is critical. 

Biomarkers can play an essential role in determining patient prognosis as well as aiding treatment decisions and assessing potential treatment response.

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Metastatic breast cancer remains largely incurable. However, with some patients achieving long-term relapse-free survival, discussion is now ongoing as to whether a subset of patients may be curable with a more aggressive multidisciplinary team approach and curable intent29

However, in the absence of a cure, the goal of treatment must be to extend life and delay disease progression while ensuring that patients continue to have the best quality of life for as long as possible3.

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There are three cyclin-dependent kinase 4/6 (CDK4/6) inhibitors which are EMA and FDA approved for the treatment of HR+/HER2- metastatic breast cancer; abemaciclib, palbociclib and ribociclib58–63

Here, we discuss the role of CDK4 and CDK6 in the regulation of the cell cycle and in breast cancer pathogenesis, as well as the mode of action for these CDK4/6 inhibitors in breast cancer.  

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The CDK4/6 inhibitors palbociclib, ribociclib and abemaciclib have all been approved for the treatment of HR+/HER2- metastatic breast cancer by the FDA and EMA58–60,76–78.

In this 4–minute video, Dr Gregory Vidal from the West Cancer Centre and Research Institute (University of Tennessee, USA) shares his view on the latest exciting developments related to the landmark clinical trials for CDK4/6 inhibitors in patients with HR+/HER2- metastatic breast cancer.

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