Overall Survival With First-Line vs Second-Line CDK4/6 Inhibitor Use in Advanced Breast Cancer

Does first-line use of cyclin-dependent kinase (CDK) 4 and 6 inhibitors (CDK4/6i) improve overall survival (OS) compared with second-line use in patients with hormone receptor–positive, -negative advanced breast cancer?In this phase 3 randomized clinical trial including 1050 patients, first-line CDK4/6i use did not improve OS compared with second-line use (median OS, 47.9 months vs 48.1 months). A post hoc subgroup analysis suggested an OS benefit with first-line use in premenopausal patients.First-line CDK4/6i use did not improve OS compared with second-line use but did increase toxic effects, with post hoc analysis suggesting an OS benefit with first-line use in premenopausal patients.

Corresponding Author: Gabe S. Sonke, PhD, Department of Medical Oncology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands (g.sonke@nki.nl).

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