Safety and quality of life of CDK4/6 inhibitors therapy for hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer: a multicenter cross-sectional survey in China

Abstract

Background

To investigate the treatment pattern, adverse events, and quality of life of Chinese patients treated with CDK4/6 inhibitors (CDK4/6i) for hormone receptor (HR)+/HER2- advanced breast cancer.

Methods

This multicenter cross-sectional survey enrolled patients with HR+/HER2- advanced breast cancer currently treated with CDK4/6i. The patients reported adverse events and quality of life during CDK4/6i treatment with a questionnaire and EORTC QLQ-BR23. Meanwhile, the oncologists collected the treatment information, adverse events and patient characteristics from medical record.

Results

The analysis included 1254 patients. Most patients received only one CDK4/6i, of which 38.92% received dalpiciclib, 35.81% received abemaciclib, 15.07% received palbociclib, and 0.47% received ribociclib, while 9.73% patients were treated with two CDK4/6i sequentially. The oncologists reported adverse events occurred in > 81.17% of patients, and most common AEs were leukopenia (63.30%) and neutropenia (58.73%). The most common symptomatic adverse events reported by the patients were fatigue (34.13%), alopecia (14.02%) and weakness (11.30%). The incidence of alopecia in patients receiving dalpiciclib was lower than in those receiving palbociclib (8.81% vs. 16.40%, P < 0.001) and abemaciclib (8.81% vs. 19.82%, P = 0.027). Regard to quality of life, breast symptom scores were lower in the palbociclib group than in the abemaciclib group (3.84 ± 8.57 vs. 5.70 ± 9.81, P = 0.047). Patient reported alopecia was associated with body image, systemic therapy side effects, breast symptoms, arm symptoms, and upset by hair loss (all P < 0.001).

Conclusions

The safety profile of different CDK4/6i varies and has different impacts on patients’ quality of life, which needs more attention in clinical practice.