Journal of Modern OncologyJournal of Modern OncologyСовременная онкология1815-14341815-1442LLC Obyedinennaya Redaktsiya32151510.26442/18151434.2023.1.202180CLINICAL ONCOLOGYКЛИНИЧЕСКАЯ ОНКОЛОГИЯReview ArticleThe effect of CDK4/6 inhibitors on the overall survival in patients with advanced HR+/HER2- BC in the entire population and in special clinical subgroups of unfavorable prognosis: A reviewВлияние ингибиторов CDK4/6 на общую выживаемость пациенток с распространенным HR+/HER2- РМЖ во всей популяции и в особых клинических подгруппах неблагоприятного прогнозаhttps://orcid.org/0000-0002-0616-5477GrechukhinaKaterina S.ГречухинаКатерина Сергеевна
Russian Federation

Cand. Sci. (Med.), Loginov Moscow Clinical Scientific Center

канд. мед. наук, зав. химио-терапевтическим отд-нием, врач-онколог Центра амбулаторной онкологической помощи ГБУЗ «МКНЦ им. А.С. Логинова»

dr.grechukhina@gmail.comhttps://orcid.org/0000-0002-8281-5646KaluginMaxim V.КалугинМаксим Вячеславович
Russian Federation

Department Head, Loginov Moscow Clinical Scientific Center

зав. отд. организационно-методической и клинико-экспертной работы, врач-онколог Центра амбулаторной онкологической помощи ГБУЗ «МКНЦ им. А.С. Логинова»

dr.grechukhina@gmail.comhttps://orcid.org/0000-0002-9600-3841ProsvirnovAndrey A.ПросвирновАндрей Александрович
Russian Federation

Oncologist, Loginov Moscow Clinical Scientific Center

врач-онколог химиотерапевтического отд-ния Центра амбулаторной онкологической помощи «ГБУЗ МКНЦ им. А.С. Логинова»

dr.grechukhina@gmail.comhttps://orcid.org/0009-0004-7119-0160SukhovaMargarita V.СуховаМаргарита Витальевна
Russian Federation

Oncologist, Loginov Moscow Clinical Scientific Center

врач-онколог дневного стационара по онкологическому профилю ГБУЗ «МКНЦ им. А.С. Логинова»

dr.grechukhina@gmail.comhttps://orcid.org/0000-0003-4848-6938ZhukovaLiudmila G.ЖуковаЛюдмила Григорьевна
Russian Federation

D. Sci. (Med.), Corr. Memb. RAS, Loginov Moscow Clinical Scientific Center

чл.-кор. РАН, д-р мед. наук, зам. дир. по онкологии ГБУЗ «МКНЦ им. А.С. Логинова»

dr.grechukhina@gmail.comLoginov Moscow Clinical Scientific CenterГБУЗ «Московский клинический научно-практический центр им. А.С. Логинова» Департамента здравоохранения г. Москвы17052023251556221032023Copyright ©; 2023, Consilium MedicumCopyright ©; 2023, ООО "Консилиум Медикум"2023Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://modernonco.orscience.ru/1815-1434/article/view/321515

An increase in the median progression-free survival when using cyclin-dependent kinase 4/6 inhibitors in combination with aromatase inhibitors led to high expectations from the analysis of the overall survival of patients with HR+/HER2- metastatic breast cancer. Of the three drugs in the group, the final data were obtained in the MONALEESA-2 and PALOMA-2 studies, while a statistically significant difference in median overall survival was achieved only with the use of ribociclib. The review discusses possible factors that could affect the final results of the presented studies. The effect of ribociclib on the value of OS in clinically unfavorable prognostic subgroups (for example, patients with visceral metastases) and on progression-free survival depending on the expression of molecular genetic factors that worsen patient survival (such as Rb, p16, Ki-67, CDKN2A, CCND1, ESR1) was analyzed.The combination of ribociclib and aromatase inhibitors has proven to be an advantage in the treatment of patients with HR+/HER2- metastatic breast cancer in terms of increasing both progression-free survival and overall survival. Efficacy has been proven in subgroups with clinical and molecular adverse prognostic factors.

Увеличение медианы выживаемости без прогрессирования при использовании ингибиторов циклин-зависимых киназ 4/6 в комбинации с ингибиторами ароматазы привело к большим ожиданиям от анализа общей выживаемости пациенток с HR+/HER2- метастатическим раком молочной железы. По трем препаратам группы окончательные данные получены в исследованиях MONALEESA-2 и PALOMA-2, при этом статистически значимая разница в медиане общей выживаемости достигнута только при использовании рибоциклиба. В обзоре проанализированы возможные факторы, которые могли повлиять на финальные результаты представленных исследований, а также влияние рибоциклиба на общую выживаемость в клинически неблагоприятных прогностических подгруппах (например, среди пациентов с висцеральными метастазами) и на выживаемость без прогрессирования в зависимости от экспрессии молекулярно-генетических факторов, ухудшающих выживаемость (Rb, p16, Ki-67, CDKN2A, CCND1, ESR1). Комбинация рибоциклиба и ингибиторов ароматазы доказала свое преимущество в терапии пациенток с HR+/HER2- метастатическим раком молочной железы с точки зрения увеличения выживаемости без прогрессирования и общей выживаемости. Доказана эффективность в подгруппах с клиническими и молекулярными неблагоприятными прогностическими факторами.

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