Real-World Outcomes of CDK4/6 Inhibitors in Germline BRCA1/2-Mutated Hormone Receptor-Positive, HER2-Negative Metastatic Breast Cancer: Turkish Oncology Group (TOG) Study.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Seyyar Mustafa, Kalem Ali, Sali Mürsel, Karabuğa Berkan, Sahin Taha Koray, Dişli Ahmet Kürşad, Türkel Alper, Karadurmuş Berkan, Şahin Hafızoğlu Ece, Avcı Nilüfer, Bilgetekin Irem, Köse Baytemur Naziyet, Uguztemur Esma, Oflazoğlu Utku, Gür Hasibe Bilge, Hacıbekiroğlu İlhan, Akkuş Aysun Fatma, Topaloğlu Sernaz, Bayramgil Ayberk, Dülgar Kaya Özgecan, Yazıcı Melike, Şakalar Teoman, Akay Seval, Majidova Nargiz, Guliyev Murad, Alan Özkan, Gülcü Serkan, Eren Tülay, İmamoğlu Gökşen İnanç, Güren Ali Kaan, Köstek Osman, Ünlü Ahmet, Ozturk Banu, Aydın Esra, Safarov Shamkhal, Doğan Bekir, Tükenmez Mehmet Akif, Demir Teyfik, Şahin Elif, Erdemoğlu Engin, Keskin Uzundere Fatma, Bütün Osman, Karabulut Bülent, Uzun Mehmet, Baydaş Tuba, Karaman Elanur, Arak Hacı, Ekinci Ferhat, Aykan Musa Barış, Ertürk İsmail, Guven Deniz Can, Deligönül Adem, Karaçin Cengiz, Ateş Öztürk, İnanç Mevlüde, Yeşil Havva, Aksoy Sercan, Köşeci Tolga, Ökten İlker Nihat, Yıldırım Hasan Çağrı, Çabuk Devrim
Аннотация
Germline BRCA1/2-mutated (gBRCAm) hormone receptor-positive/HER2-negative (HR+/HER2-) metastatic breast cancer (MBC) is a biologically distinct subset in which the efficacy of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors remains incompletely characterized. We evaluated real-world outcomes and prognostic factors in a multicenter retrospective Turkish cohort treated with a CDK4/6 inhibitor plus endocrine therapy (June 2020-September 2025). Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan-Meier and Cox methods. Among 121 patients, 30 (24.8%) had BRCA1, 88 (72.7%) had BRCA2, and three (2.5%) had dual mutations; 66.9% received first-line therapy, with ribociclib in 69.4% and palbociclib in 29.8%. Objective response rate was 69.4% and the clinical benefit rate was 82.6%. Median PFS was 17.0 months and OS 47.0 months. PFS was numerically longer in BRCA1 than in BRCA2 carriers (25.0 vs. 14.0 months), although the difference was not statistically significant in the pairwise comparison (HR 1.50, 95% CI 0.88-2.56; log-rank p = 0.135); the dual BRCA1/2 subgroup (n = 3) had the poorest outcomes and was assessed descriptively. OS did not differ significantly between BRCA1 and BRCA2 carriers (57.0 vs. 49.0 months; log-rank p = 0.520). PFS did not differ between ribociclib and palbociclib (p = 0.192); OS favored ribociclib at borderline significance (p = 0.050), but this was not confirmed in Cox regression. In multivariable analysis, ECOG ≥ 1 (HR 1.85; p = 0.010) and fulvestrant-based therapy (HR 1.74; p = 0.041) predicted shorter PFS; fulvestrant also predicted worse OS (HR 2.39; p = 0.008). CDK4/6 inhibitor-based therapy shows meaningful activity in gBRCAm HR+/HER2- MBC; the numerically poorer outcomes observed in BRCA2 carriers are hypothesis-generating and warrant validation in larger cohorts.