An informative, structured abstract of no more than 250 words should accompany each manuscript. Abstracts for original contributions should be structured into the following sections： AIM： Only the purpose should be ...An informative, structured abstract of no more than 250 words should accompany each manuscript. Abstracts for original contributions should be structured into the following sections： AIM： Only the purpose should be included. METHODS： The materials, techniques, instruments and equipments, and the experimental procedures should be included. RESULTS： The observatory and experimental results, including data, effects, outcome, etc. should be included. Authors should present P value where necessary, and the significant data should accompany. CONCLUSION： Accurate view and the value of the results should be included. The format of structured abstracts is at： http：//www.wjgnet.com/wjg/help/11 .doc展开更多
Background:CDK4/6 inhibitors(CDK4/6i)have shown promising results in the treatment of hormone receptor‐positive(HR+)metastatic breast cancer(MBC)when combined with endocrine therapy(ET).It is crucial to evaluate the ...Background:CDK4/6 inhibitors(CDK4/6i)have shown promising results in the treatment of hormone receptor‐positive(HR+)metastatic breast cancer(MBC)when combined with endocrine therapy(ET).It is crucial to evaluate the actual effectiveness and safety of CDK4/6i in clinical practice,as well as to analyze the factors that can predict their outcomes.Methods:Patients with HR+MBC who received CDK4/6i‐based therapy between May 2016 and May 2023 at Hunan Cancer Hospital were evaluated for progression‐free survival(PFS).Adverse reactions were assessed based on the National Cancer Institute Common Toxicity Criteria(version 5.0).Results:This study included 344 patients,with a median PFS(mPFS)of 12.8 months(range:10.4–15.2 months).After adjustment,Cox multivariate regression analysis revealed that visceral metastasis(specifically liver and brain metastases),Eastern Cooperative Oncology Group Performance Status(ECOG PS)≥1,estrogen receptor≤80%,progesterone receptor≤10%,Ki‐67>30%,and treatment in later stages were significant factors associated with reduced PFS.Based on this,we created a prognostic nomogram and validated its performance,obtaining a C‐index of 0.714(95%confidence interval:0.640–0.787)as well as reliable calibration and clinical impact.The mPFS of CDK4/6i rechallenge was 7.7 months;for patients who initially discontinued CDK4/6i for reasons other than disease progression,CDK4/6i rechallenge still provided a mPFS of 11.4 months.The tolerability and safety of combining CDK4/6is with ET were manageable.Adverse events led to treatment discontinuation in 3.8%of patients.Neutropenia(29.1%),leukopenia(13.7%),and anemia(4.1%)were the primary grade 3/4 adverse reactions.Conclusions:This real‐world study highlights the ample efficacy and reasonable safety of combined CDK4/6i and ET in patients with HR+MBC.Individualized treatment decisions and ongoing safety monitoring are important to optimize the therapeutic benefit of CDK4/6i treatment.展开更多
文摘An informative, structured abstract of no more than 250 words should accompany each manuscript. Abstracts for original contributions should be structured into the following sections： AIM： Only the purpose should be included. METHODS： The materials, techniques, instruments and equipments, and the experimental procedures should be included. RESULTS： The observatory and experimental results, including data, effects, outcome, etc. should be included. Authors should present P value where necessary, and the significant data should accompany. CONCLUSION： Accurate view and the value of the results should be included. The format of structured abstracts is at： http：//www.wjgnet.com/wjg/help/11 .doc
基金Hunan Provincial Natural Science Foundation of China,Grant/Award Numbers:2023JJ60334,2023JJ60464,2024JJ6289Beijing Science and Technology Innovation Medical Development Foundation,Grant/Award Number:KC2023‐JX‐0082‐05The Climb Plan of Hunan Cancer Hospital,Grant/Award Numbers:QH2023006,ZX2021005。
文摘Background:CDK4/6 inhibitors(CDK4/6i)have shown promising results in the treatment of hormone receptor‐positive(HR+)metastatic breast cancer(MBC)when combined with endocrine therapy(ET).It is crucial to evaluate the actual effectiveness and safety of CDK4/6i in clinical practice,as well as to analyze the factors that can predict their outcomes.Methods:Patients with HR+MBC who received CDK4/6i‐based therapy between May 2016 and May 2023 at Hunan Cancer Hospital were evaluated for progression‐free survival(PFS).Adverse reactions were assessed based on the National Cancer Institute Common Toxicity Criteria(version 5.0).Results:This study included 344 patients,with a median PFS(mPFS)of 12.8 months(range:10.4–15.2 months).After adjustment,Cox multivariate regression analysis revealed that visceral metastasis(specifically liver and brain metastases),Eastern Cooperative Oncology Group Performance Status(ECOG PS)≥1,estrogen receptor≤80%,progesterone receptor≤10%,Ki‐67>30%,and treatment in later stages were significant factors associated with reduced PFS.Based on this,we created a prognostic nomogram and validated its performance,obtaining a C‐index of 0.714(95%confidence interval:0.640–0.787)as well as reliable calibration and clinical impact.The mPFS of CDK4/6i rechallenge was 7.7 months;for patients who initially discontinued CDK4/6i for reasons other than disease progression,CDK4/6i rechallenge still provided a mPFS of 11.4 months.The tolerability and safety of combining CDK4/6is with ET were manageable.Adverse events led to treatment discontinuation in 3.8%of patients.Neutropenia(29.1%),leukopenia(13.7%),and anemia(4.1%)were the primary grade 3/4 adverse reactions.Conclusions:This real‐world study highlights the ample efficacy and reasonable safety of combined CDK4/6i and ET in patients with HR+MBC.Individualized treatment decisions and ongoing safety monitoring are important to optimize the therapeutic benefit of CDK4/6i treatment.
