Abstract 232P
Background
Everolimus + Exemestane (E+E) has been in use for patients with metastatic hormone receptor-positive breast cancer who progress on nonsteroidal aromatase inhibitor treatment, since the BOLERO – 2 trial. However, the patient population in BOLERO 2 had previous treatments with hormones / chemotherapy only. CDK 4/6 inhibitors were approved for use in 2017 in the UK, and since then have been a standard 1st line of treatment in the hormone receptor-positive metastatic breast cancer setting. Primary objective: To assess real world outcomes with Everolimus and Exemestane in advanced breast cancer, after cdk4/6 inhibitors came into use, mainly in terms of Progression Free Survival (PFS). Secondary objective: To assess what treatment patients receive after progression on Everolimus and Exemestane.
Methods
Retrospective analysis of patient medical records was done. Patients who were treated with Everolimus + Exemestane after CDK 4/6 inhibitor use, in hormone receptor-positive metastatic breast cancer setting were analysed. Timeline of study: 5 years(Dec. 2017 to Dec. 2022) Data collected: basic patient demographics, E+E dose, line of treatment, number of cycles, next line of management after stopping E+E. PFS calculated and presented as Kaplan Mier Curve.
Results
A total 69 patients received E+E after use of a CDK 4/6 inhibitor. Median age was 60 years. 86% had been treated with Palbociclib, 9% Abemaciclib and 6 % with Ribociclib. 53 patients had used CDK 4/6 inhibtors in the first-line. 43 and 21 patients had E+E in the second and third line respectively. 94% patients were of WHO PS 0 or 1. 53.6% carried on with E+E to about 4-12 weeks. About 15 % continued treatment upto 36 weeks.28% patients had Everolimus stopped due to toxicity. 7 patients were still on E+E when analysis was done, while 3 died on it or on a break from it. Median PFS was 5 months. 60% switched to chemotherapy, 8% hormones only, 15% BSC.
Conclusions
Everolimus and Exemestane results in median PFS of 5 months, post cdk 4/6 inhibitors. This is not in line with BOLERO 2 trial(PFS of 10.6 months), indicating this may not be the best option now. Larger real world studies are required to corroborate this statement.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.