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Article

Palbociclib Plus Fulvestrant or Everolimus Plus Exemestane for Pretreated Advanced Breast Cancer with Lobular Histotype in ER+/HER2− Patients: A Propensity Score-Matched Analysis of a Multicenter Retrospective Patient Series

1
Comprehensive Cancer Center, UOC di Oncologia Medica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
2
Division of Medical Oncology, Regina Elena National Cancer Institute IRCCS, 00128 Rome, Italy
3
Medical Oncology, Central Hospital of Belcolle, 01100 Viterbo, Italy
4
Clinical and Molecular Medicine Department, Sapienza University of Rome, 00185 Rome, Italy
5
Comprehensive Cancer Center Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
6
Oncology Department, Ospedale di Frosinone, 03100 Frosinone, Italy
7
Oncology Department, Azienda Ospedaliero-Universitaria Policlinico di Modena, 41125 Modena, Italy
8
Medical Oncology, Department of Traslational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
9
Biostatistical Unit, Regina Elena National Cancer Institute IRCCS, 00128 Rome, Italy
10
Multidisciplinary Breast Center, Dipartimento Scienze della Salute della donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy
*
Author to whom correspondence should be addressed.
Preliminary results of this study were presented at a poster session at ESMO 2019 (339P) Abstract published in Annals of Oncology, 30, Supplement 5, October 2019.
Equally contributors.
J. Pers. Med. 2020, 10(4), 291; https://doi.org/10.3390/jpm10040291
Received: 10 November 2020 / Revised: 10 December 2020 / Accepted: 16 December 2020 / Published: 18 December 2020
(This article belongs to the Special Issue Innovations in the Integrated Management of Breast Cancer)
Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) in combination with endocrine therapy (ET) show meaningful efficacy and tolerability in patients with metastatic breast cancer (MBC), but the optimal sequence of ET has not been established. It is not clear if patients with lobular breast carcinomas (LBC) derive the same benefits when receiving second line CDK4/6i. This retrospective study compared the efficacy of palbociclib plus fulvestrant (PALBO–FUL) with everolimus plus exemestane (EVE–EXE) as second-line ET for hormone-resistant metastatic LBC. From 2013 to 2018, patients with metastatic LBC positivity for estrogen and/or progesterone receptors and HER2/neu negativity, who had relapsed during adjuvant hormonal therapy or first-line hormonal treatment, were enrolled from six centers in Italy in this retrospective study. A total of 74 out of 376 patients (48 treated with PALBO–FUL and 26 with EVE–EXE) with metastatic LBC were eligible for inclusion. Progression-free survival (PFS) was longer in patients receiving EVE–EXE compared with PALBO–FUL (6.1 vs. 4.5 months, univariate HR 0.58, 95% CI 0.35–0.96; p = 0.025). On the propensity score (PS) analysis, PFS was confirmed to be significantly longer for patients treated with EVE–EXE compared to PALBO–FUL (6.0 vs. 4.6 months, p = 0.04). This retrospective analysis suggests that EVE–EXE is more effective than PALBO–FUL for second line ET of metastatic LBC, allowing us to speculate on the optimal therapeutic sequence. View Full-Text
Keywords: advanced breast cancer; mTOR inhibitor; CDK4/6 inhibitor; endocrine resistance advanced breast cancer; mTOR inhibitor; CDK4/6 inhibitor; endocrine resistance
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MDPI and ACS Style

Orlandi, A.; Iattoni, E.; Pizzuti, L.; Fabbri, A.; Botticelli, A.; Di Dio, C.; Palazzo, A.; Garufi, G.; Indellicati, G.; Alesini, D.; Carbognin, L.; Paris, I.; Vaccaro, A.; Moscetti, L.; Fabi, A.; Magri, V.; Naso, G.; Cassano, A.; Vici, P.; Giannarelli, D.; Franceschini, G.; Marchetti, P.; Bria, E.; Tortora, G. Palbociclib Plus Fulvestrant or Everolimus Plus Exemestane for Pretreated Advanced Breast Cancer with Lobular Histotype in ER+/HER2− Patients: A Propensity Score-Matched Analysis of a Multicenter Retrospective Patient Series. J. Pers. Med. 2020, 10, 291. https://doi.org/10.3390/jpm10040291

AMA Style

Orlandi A, Iattoni E, Pizzuti L, Fabbri A, Botticelli A, Di Dio C, Palazzo A, Garufi G, Indellicati G, Alesini D, Carbognin L, Paris I, Vaccaro A, Moscetti L, Fabi A, Magri V, Naso G, Cassano A, Vici P, Giannarelli D, Franceschini G, Marchetti P, Bria E, Tortora G. Palbociclib Plus Fulvestrant or Everolimus Plus Exemestane for Pretreated Advanced Breast Cancer with Lobular Histotype in ER+/HER2− Patients: A Propensity Score-Matched Analysis of a Multicenter Retrospective Patient Series. Journal of Personalized Medicine. 2020; 10(4):291. https://doi.org/10.3390/jpm10040291

Chicago/Turabian Style

Orlandi, Armando; Iattoni, Elena; Pizzuti, Laura; Fabbri, Agnese; Botticelli, Andrea; Di Dio, Carmela; Palazzo, Antonella; Garufi, Giovanna; Indellicati, Giulia; Alesini, Daniele; Carbognin, Luisa; Paris, Ida; Vaccaro, Angela; Moscetti, Luca; Fabi, Alessandra; Magri, Valentina; Naso, Giuseppe; Cassano, Alessandra; Vici, Patrizia; Giannarelli, Diana; Franceschini, Gianluca; Marchetti, Paolo; Bria, Emilio; Tortora, Giampaolo. 2020. "Palbociclib Plus Fulvestrant or Everolimus Plus Exemestane for Pretreated Advanced Breast Cancer with Lobular Histotype in ER+/HER2− Patients: A Propensity Score-Matched Analysis of a Multicenter Retrospective Patient Series" J. Pers. Med. 10, no. 4: 291. https://doi.org/10.3390/jpm10040291

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