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The Evolving Role of CDK4/6 Inhibitors in Early and Recurrent Breast Cancer: Clinical and Translational Findings and Work in Progress

A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: 31 December 2026 | Viewed by 591

Editor


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Guest Editor
Department of Gynecology and Obstetrics, Knappschaft Kliniken Marienhospital Bottrop, Josef-Albers-Straße 70, 46236 Bottrop, Germany
Interests: breast cancer; de-escalation strategies; intraoperative radiotherapy; neoadjuvant therapy; immune therapy
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Special Issue Information

Dear Colleagues,

Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors have fundamentally transformed the therapeutic landscape for hormone receptor-positive, HER2-negative breast cancer, establishing a new standard of care in both advanced and high-risk early-stage disease when combined with endocrine therapy. The clinical success of agents such as palbociclib, ribociclib, and abemaciclib is underpinned by their ability to arrest cell cycle progression at the G1/S checkpoint, resulting in significant improvements in progression-free and overall survival for select patient populations. Beyond their cytostatic effects, recent research has revealed that CDK4/6 inhibition exerts broader biological impacts—including modulation of tumor metabolism—induction of cellular senescence, and enhancement of antitumor immunity, thereby opening new avenues for combination strategies and expanding their potential utility across diverse malignancies.

Despite these advances, several challenges remain, including the emergence of acquired resistance, identification of predictive biomarkers, and the optimization of treatment sequencing and combination regimens. Ongoing translational and clinical research is focused on elucidating mechanisms of resistance, refining patient selection, and exploring novel therapeutic combinations to maximize clinical benefit. This Special Issue aims to provide a comprehensive overview of the current state of clinical and translational CDK4/6 inhibitor research in both the early and metastatic settings, highlight recent mechanistic insights, and discuss future directions for clinical application and drug development in oncology.

Prof. Dr. Hans-Christian Kolberg
Guest Editor

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Keywords

  • CDK4/6 inhibitors
  • breast cancer
  • treatment resistance
  • combination therapy
  • biomarkers

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Published Papers (1 paper)

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Review

22 pages, 1245 KB  
Review
CDK4/6 Inhibitors in Breast Cancer: Clinical Applications, Translational Insights, and Future Directions
by Mengying Guan and Hua Hao
Cancers 2026, 18(15), 2376; https://doi.org/10.3390/cancers18152376 - 23 Jul 2026
Viewed by 281
Abstract
Cyclin-dependent kinase 4/6 inhibitors have fundamentally changed the management of hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer. However, these drugs are not interchangeable and the field is moving away from the notion of a uniform “class effect.” In early breast [...] Read more.
Cyclin-dependent kinase 4/6 inhibitors have fundamentally changed the management of hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer. However, these drugs are not interchangeable and the field is moving away from the notion of a uniform “class effect.” In early breast cancer, adjuvant abemaciclib and ribociclib improve invasive disease-free survival in patients at a high risk of recurrence, whereas palbociclib does not. This difference likely stems from agent-specific pharmacological profiles, differences in trial design, and patient selection, rather than simply dosing nuances. In metastatic breast cancer, all three agents prolong progression-free survival when combined with endocrine therapy, but only ribociclib and potentially abemaciclib have shown an overall survival advantage. In addition, resistance remains a major obstacle in clinical practice. We propose that resistance mechanisms can be meaningfully grouped into two categories: target-driven (e.g., RB1 loss, CDK6 amplification) and bypass-driven (e.g., ESR1 mutations, PI3K/AKT pathway activation, APOBEC3-mediated mutagenesis). Distinguishing between these classes helps in the design of rational sequencing algorithms and combinatorial regimens. Emerging strategies, such as next-generation protein degraders, oral selective estrogen receptor degraders, antibody–drug conjugates, and inhibition of autophagy, are promising methods for overcoming resistance. Moving forward, the greatest need in breast cancer treatment will be not simply developing additional agents but using current therapies more intelligently by refining biomarker-guided patient selection, tailoring treatment duration, and ensuring broad global access. Full article
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