Therapy options after CDK4/6 inhibitors for HR+, HER2- postmenopausal metastatic/recurrent breast cancer in Japan: a role for mammalian target of rapamycin inhibitors?

Future Oncol. 2020 Aug;16(24):1851-1862. doi: 10.2217/fon-2020-0326. Epub 2020 Jul 2.

Abstract

Despite advances in the treatment of hormone receptor-positive, HER2- metastatic breast cancer, the disease is rarely curable. In this review, we focus on the use of CDK4/6 inhibitors, examining clinical experience and the mechanisms underlying the development of resistance, and evaluating treatment options after failure to respond to CDK4/6 inhibitors. Current basic research supports the use of mammalian target of rapamycin inhibitors after CDK4/6 inhibitor failure; however, more data are needed, particularly regarding treatment sequencing. Real-world data studies may help to fill the current knowledge gap, particularly where large-scale randomized controlled studies are not feasible.

Keywords: CDK4/6 inhibitors; HR+ HER2- metastatic breast cancer; best practice; mTOR inhibitors; real-world data; resistance; treatment sequencing.

MeSH terms

  • Biomarkers, Tumor / metabolism*
  • Breast Neoplasms / etiology
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy*
  • Cyclin-Dependent Kinase 4 / antagonists & inhibitors
  • Cyclin-Dependent Kinase 6 / antagonists & inhibitors
  • Disease Management
  • Drug Resistance, Neoplasm / drug effects
  • Drug Resistance, Neoplasm / genetics
  • Female
  • Humans
  • Japan
  • Neoplasm Staging
  • Phosphatidylinositol 3-Kinases / metabolism
  • Postmenopause
  • Protein Kinase Inhibitors / pharmacology
  • Protein Kinase Inhibitors / therapeutic use
  • Proto-Oncogene Proteins c-akt / metabolism
  • Receptor, ErbB-2 / metabolism
  • Receptors, Estrogen / metabolism
  • Receptors, Progesterone / metabolism
  • Retreatment
  • Signal Transduction
  • TOR Serine-Threonine Kinases / metabolism

Substances

  • Biomarkers, Tumor
  • Protein Kinase Inhibitors
  • Receptors, Estrogen
  • Receptors, Progesterone
  • Receptor, ErbB-2
  • Proto-Oncogene Proteins c-akt
  • TOR Serine-Threonine Kinases
  • Cyclin-Dependent Kinase 4
  • Cyclin-Dependent Kinase 6