Prediction of dose reductions and impact of reduced starting doses of CDK4/6i on effectiveness in HR-positive/HER2-negative metastatic breast cancer: Real-world data from the OPAL registry - PubMed
3 hours ago
- #dose reduction
- #metastatic breast cancer
- #CDK4/6 inhibitors
- Study develops a predictive index to identify HR-positive/HER2-negative metastatic breast cancer (MBC) patients likely to require dose reduction of CDK4/6 inhibitors (palbociclib or ribociclib).
- Real-world data from the OPAL registry (618 patients) shows 35% underwent dose reduction within 6 months, with 51% starting at reduced doses (RSD).
- Key predictors for dose reduction: age ≥65 years and Charlson comorbidity index (CCI) ≥1.
- Patients with high probability of dose reduction (age ≥65 and/or CCI ≥1) had comparable progression-free survival (PFS) and overall survival (OS) with RSD vs. full starting dose (FSD).
- Younger/fitter patients (age <65, CCI=0) had better outcomes with FSD, suggesting they may require full dosing.
- Findings support tailored dosing strategies but need validation via randomized controlled trials.