Safety of CDK4/6 Inhibitors Combined with Radiotherapy in Patients with Metastatic Breast Cancer: A Review of the Literature

Curr Oncol. 2023 Jun 6;30(6):5485-5496. doi: 10.3390/curroncol30060415.

Abstract

Recent evidence suggests that cyclin-dependent kinase 4/6 (CDK4/6) inhibitors significantly improve progression-free survival and overall survival among metastatic breast cancer patients. However, given the effects on cell cycle arrest, there is potential for CDK4/6 inhibitors and radiotherapy (RT) to work synergistically, enhancing the effect and toxicities of RT. A comprehensive review of the literature on the combination of RT and CDK4/6 inhibitors was performed with 19 eligible studies included in the final analysis. A total of 373 patients who received radiotherapy combined with CDK4/6 inhibitors were evaluated across 9 retrospective studies, 4 case reports, 3 case series, and 3 letters to the editor. The CDK4/6 inhibitor used, RT target, and RT technique were assessed in terms of toxicities. This literature review demonstrates generally limited toxicities with the combination of CDK4/6 inhibitors and palliative radiotherapy to metastatic breast cancer patients. The current evidence is nonetheless limited, and further results of ongoing prospective clinical trials will help clarify whether these treatments can be safely combined.

Keywords: breast cancer; cyclin-dependent kinase inhibitors; radiotherapy.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / radiotherapy
  • Cyclin-Dependent Kinase 4
  • Female
  • Humans
  • Progression-Free Survival
  • Prospective Studies
  • Protein Kinase Inhibitors / adverse effects
  • Retrospective Studies

Substances

  • Protein Kinase Inhibitors
  • Cyclin-Dependent Kinase 4
  • CDK4 protein, human

Grants and funding

The authors received an unrestricted educational grant from Pfizer Canada.