Comparative Efficacy of Anastrozole, Letrozole, and Fulvestrant as Endocrine Partners Combined with CDK4/6 Inhibitors in Patients with HR+/HER2– Metastatic Breast Cancer: A Real-World Evidence from the Stavropol Regional Clinical Oncology Center

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Abstract

Introduction. Combining CDK4/6 inhibitors with various м endocrine partners is a key therapeutic strategy in clinical prac- - tice, enabling treatment personalization and improved outcomes с for patients with HR+/HER2– metastatic breast cancer (MBC). - Aim. To evaluate the comparative effectiveness of different - endocrine therapy regimens combined with CDK4/6 inhibitors о using real-world data from the Stavropol Regional Clinical Oncology Center. - Materials and Methods. This retrospective analysis inыcluded 83 patients with HR+/HER2– MBC who received ribo- - ciclib (n = 42, 51 %) or palbociclib (n = 41, 49 %) in combiбnation with anastrozole, letrozole, or fulvestrant between April м 2019 and April 2024. Treatment efficacy was assessed through ь relapse-free survival (RFS) analysis using the Kaplan-Meier й method, with curve comparisons evaluated by log-rank test. Results. Anastrozole demonstrated significantly superior survival compared to letrozole (p < 0.001), while showing no statistically significant difference from fulvestrant (p = 0.168). The median RFS was not reached in the anastrozole group, both in the overall population and ribociclib subgroup. Letrozole showed more modest outcomes with median RFS of 5 months in the ribociclib group and 3-6 months in the palbociclib group. Comparative analysis revealed statistically significant advantages for ribociclib over palbociclib when combined with fulvestrant (p = 0.019), demonstrating median RFS of 22 months versus 10 months, respectively. Conclusion. These findings highlight the need for further research to optimize HR+/HER2– MBC treatment strategies, considering individual patient characteristics and complex clinical scenarios.

About the authors

O. N Shkodenko

Stavropol Regional Clinical Oncology Center

Email: muhadinovyasiyn@yandex.ru
ORCID iD: 0009-0003-3722-1237
SPIN-code: 5314-4080
Stavropol, the Russian Federation

V. O Kubyshkina

Stavropol Regional Clinical Oncology Center

Email: muhadinovyasiyn@yandex.ru
ORCID iD: 0009-0006-6547-2051
SPIN-code: 9789-1400
Stavropol, the Russian Federation

Y. A Mukhadinov

Stavropol Regional Clinical Oncology Center

Email: muhadinovyasiyn@yandex.ru
ORCID iD: 0009-0008-7411-0620
Stavropol, the Russian Federation

K. V Hurtsev

Stavropol Regional Clinical Oncology Center

Email: muhadinovyasiyn@yandex.ru
ORCID iD: 0009-0007-9921-4859
SPIN-code: 3594-3543
Stavropol, the Russian Federation

A. A Koichuev

Stavropol Regional Clinical Oncology Center

Email: muhadinovyasiyn@yandex.ru
ORCID iD: 0000-0003-2856-1056
SPIN-code: 2196-6568
Stavropol, the Russian Federation

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