Prognostic characteristics in hormone receptor-positive advanced breast cancer and characterization of abemaciclib efficacy

Angelo Di Leo, Joyce O’Shaughnessy, George W. Sledge, Miguel Martin, Yong Lin, Martin Frenzel, Molly C. Hardebeck, Ian C. Smith, Antonio Llombart-Cussac, Matthew P. Goetz, Stephen Johnston

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

CDK4 & 6 inhibitors have enhanced the effectiveness of endocrine therapy (ET) in patients with advanced breast cancer (ABC). This paper presents exploratory analyses examining patient and disease characteristics that may inform in whom and when abemaciclib should be initiated. MONARCH 2 and 3 enrolled women with HR+, HER2- ABC. In MONARCH 2, patients whose disease had progressed while receiving ET were administered fulvestrant+abemaciclib/placebo. In MONARCH 3, patients received a nonsteroidal aromatase inhibitor+abemaciclib/placebo as initial therapy for advanced disease. A combined analysis of the two studies was performed to determine significant prognostic factors. Efficacy results (PFS and ORR in patients with measurable disease) were examined for patient subgroups corresponding to each significant prognostic factor. Analysis of clinical factors confirmed the following to have prognostic value: bone-only disease, liver metastases, tumor grade, progesterone receptor status, performance status, treatment-free interval (TFI) from the end of adjuvant ET, and time from diagnosis to recurrence. Prognosis was poorer in patients with liver metastases, progesterone receptor-negative tumors, high grade tumors, or short TFI (<36 months). Benefit (PFS hazard ratio, ORR increase) from abemaciclib was observed in all patient subgroups. Patients with indicators of poor prognosis had the largest benefit from the addition of abemaciclib. However, in MONARCH 3, for patients with certain good prognostic factors (TFI ≥ 36 months, bone-only disease) ET achieved a median PFS of >20 months. These analyses identified prognostic factors and demonstrated that patients with poor prognostic factors derived the largest benefit from the addition of abemaciclib.

Original languageEnglish (US)
Article number41
Journalnpj Breast Cancer
Volume4
Issue number1
DOIs
StatePublished - Dec 1 2018

    Fingerprint

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Pharmacology (medical)

Cite this

Di Leo, A., O’Shaughnessy, J., Sledge, G. W., Martin, M., Lin, Y., Frenzel, M., Hardebeck, M. C., Smith, I. C., Llombart-Cussac, A., Goetz, M. P., & Johnston, S. (2018). Prognostic characteristics in hormone receptor-positive advanced breast cancer and characterization of abemaciclib efficacy. npj Breast Cancer, 4(1), [41]. https://doi.org/10.1038/s41523-018-0094-2