Summary

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• Ibrance (palbociclib) is indicated for the treatment of adult patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer in combination with an aromatase inhibitor as initial endocrine-based therapy in postmenopausal women or in men, and with Fulvestrant in patients with disease progression following endocrine therapy.
• This summary is based on the review of 23 systematic review(s)/meta-analysis(es). ^[1-23]
• Overall Survival (OS): CDK4/6 inhibitors (palbociclib, ribociclib, abemaciclib) showed no statistically significant differences in OS, with similar benefits in advanced/metastatic breast cancer when combined with endocrine therapy. Palbociclib did not show a statistically significant hazard ratio (HR) for OS, unlike other CDK4/6 inhibitors.
• Progression-Free Survival (PFS): Palbociclib, ribociclib, and abemaciclib significantly improved PFS when combined with endocrine therapy compared to placebo, with palbociclib ranking first in PFS outcomes in hormone receptor-positive/HER2-negative metastatic breast cancer.
• Tumor Response and Clinical Benefit Rate: CDK4/6 inhibitors combined with endocrine therapy improved objective response rates and clinical benefit rates, with real-world evidence indicating palbociclib improved outcomes in HR+/HER2- advanced/metastatic breast cancer.
• Specific Subgroup Analysis: Palbociclib showed similar efficacy in older patients (≥65 years) compared to younger patients, while ribociclib combined with endocrine therapy demonstrated significant efficacy in premenopausal women.
• CDK4/6 inhibitors (palbociclib, ribociclib, abemaciclib) were generally well-tolerated across studies, though specific adverse events varied among the drugs.
• Palbociclib and ribociclib were associated with higher rates of neutropenia, while abemaciclib exhibited significantly higher gastrointestinal toxicity, including diarrhea.
• Ribociclib had an increased incidence of hepatotoxicity and QTc prolongation, and abemaciclib had higher treatment discontinuation rates due to adverse events compared to palbociclib and ribociclib.
• There is no population type or subgroup information available in the reviewed studies.