Integration of Postoperative Radiation Therapy with Cyclin-Dependent Kinase (CDK) Inhibitors

Curr Oncol Rep. 2023 Oct;25(10):1153-1159. doi: 10.1007/s11912-023-01444-y. Epub 2023 Aug 25.

Abstract

Purpose of review: Sequential use of radiation therapy before cyclin-dependent kinase (CDK) inhibitors in women with early breast cancer seems reasonable and with a low toxicity rate. This study aimed to evaluate the possible interaction between RT and CDK inhibitors in the adjuvant setting for patients with positive hormone receptors and HER-2 negative, investigating toxicity and the treatment sequencing.

Recent findings: CDK inhibitors have been studied in patients with localized breast cancer and can improve invasive disease-free survival outcomes. Regarding the time of RT, all trials used CDK inhibitors after the RT. Interruptions in the CDK inhibitors were performed in 27.1% in Pallas, 17.5% in Penelope-B, and 16.6% in Monarch-E trials due to adverse events. Data from the Natalee trial are still not reported. The main adverse event grade III was neutropenia, with good resolution of the symptoms over time. CDK inhibitors applied sequentially and after RT postoperative showed a low profile of acute toxicity and suitable oncological outcomes.

Keywords: Abemaciclib; Breast cancer; CDK inhibitor; CDK4/6i; Palbociclib; Radiation therapy; Ribociclib.

Publication types

  • Review

MeSH terms

  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / radiotherapy
  • Cyclin-Dependent Kinase 4
  • Cyclin-Dependent Kinase 6
  • Cyclin-Dependent Kinases
  • Disease-Free Survival
  • Female
  • Humans
  • Medical Oncology
  • Protein Kinase Inhibitors / therapeutic use

Substances

  • Cyclin-Dependent Kinases
  • Protein Kinase Inhibitors
  • Cyclin-Dependent Kinase 4
  • Cyclin-Dependent Kinase 6