Thrombosis in breast cancer patients on cyclin-dependent kinase inhibitors: Survival impact and predictive factors - A study by the cancer and thrombosis group of the spanish society of medical oncology (SEOM)

Eur J Intern Med. 2024 Dec:130:98-105. doi: 10.1016/j.ejim.2024.08.005. Epub 2024 Aug 21.

Abstract

Thrombosis may be included in the profile of side effects associated with CDK4/6 inhibitors. Its significance might be greater than reported in randomized clinical trials. To investigate this, a retrospective, multicenter study was conducted. The primary objective was to calculate the incidence of thrombosis associated with CDK4/6 inhibitors. Secondary objectives included examining the impact of thrombosis on survival and identifying predictor variables for the development of venous thromboembolism (VTE) or arterial thrombosis (AT). A total of 986 patients were recruited. The incidence of VTE/AT associated with CDK4/6 inhibitor treatment during the follow-up period was 5.48 %. Survival analysis did not indicate that the development of VTE/AT during CDK4/6 inhibitor treatment significantly impacted patient survival (p = 0.133). In our analysis, two variables were found to be statistically significant (p < 0.05) as predictors of VTE/AT in breast cancer patients receiving CDK4/6 inhibitor therapy. These variables were the presence of central nervous system (CNS) metastasis with an odds ratio (OR) of 3.68 (95 % CI 1.18 - 11.49) and the use of abemaciclib with an OR of 2.3 (95 % CI 1.16 - 4.57).

Keywords: Breast cancer; Cancer-associated thrombosis; Cyclin-dependent kinase 4 and 6 inhibitor.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aminopyridines* / adverse effects
  • Aminopyridines* / therapeutic use
  • Benzimidazoles* / adverse effects
  • Benzimidazoles* / therapeutic use
  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / mortality
  • Cyclin-Dependent Kinase 4* / antagonists & inhibitors
  • Cyclin-Dependent Kinase 6* / antagonists & inhibitors
  • Female
  • Humans
  • Incidence
  • Middle Aged
  • Piperazines
  • Protein Kinase Inhibitors* / adverse effects
  • Protein Kinase Inhibitors* / therapeutic use
  • Purines
  • Pyridines / adverse effects
  • Pyridines / therapeutic use
  • Retrospective Studies
  • Spain / epidemiology
  • Survival Analysis
  • Thrombosis / epidemiology
  • Venous Thromboembolism / chemically induced
  • Venous Thromboembolism / epidemiology

Substances

  • Protein Kinase Inhibitors
  • Benzimidazoles
  • abemaciclib
  • Cyclin-Dependent Kinase 4
  • Cyclin-Dependent Kinase 6
  • Aminopyridines
  • Pyridines
  • palbociclib
  • ribociclib
  • CDK4 protein, human
  • Piperazines
  • Purines