Cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitors combined with hormonal therapy are the current standard frontline treatment for patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2 (HER-2)-negative metastatic breast cancer (MBC). However, the optimal treatment after progression on CDK4/6 inhibitors remains unknown. Anlotinib is an oral multi-target tyrosine kinase inhibitor (TKI) that strongly inhibits VEGFR, PDGFR, FGFR, and c-kit. This study aimed to evaluate the safety and efficacy of anlotinib-based combination therapy in patients with HR+ MBC previously treated with a CDK4/6 inhibitor.
Female patients aged 18 to 75 years, with an ECOG score of 0-1, and an expected survival of at least 3 months;
Presence of measurable lesions as defined by RECIST 1.1 criteria;
Histopathologically confirmed HR-positive/HER2-negative breast cancer. HER2 negativity is determined by an immunohistochemistry (IHC) result of HER2 (0/1+). If the result is HER2 (++), a FISH or CISH test is required to confirm the absence of HER2 amplification;
Patients who have undergone multiple lines of advanced therapy with no remaining standard treatment options;
Patients with HER2-positive breast cancer confirmed by histology or cytology;
Patients who discontinued therapy due to non-disease progression reasons, such as adverse events or other non-medical factors;
Detection of a second primary malignant tumor at the time of enrollment;
Failure to complete CDK4/6 inhibitor therapy;
HR+ metastatic breast cancer previously treated with CDK4/6is
Other
Retrospective
Anlotinib+eribulin/nab-paclitaxel/etoposide/capecitabine/pembrolizumab/ sintilimab/ fulvestrant, etc
Other interventionAnlotinib (8/10/12 mg daily, Day 1-14 of each cycle) was administered orally to fasting patients, with dose reductions to 10 mg or 8 mg in cases of intolerable toxicity. Combination agents included eribulin, nab-paclitaxel, etoposide, capecitabine, pembrolizumab, sintilimab, or fulvestrant, among others.
Progression free survival (PFS)
Progression-free survival estimated using Kaplan-Meier methods is defined as the time from the date of informed consent to the earlier of death or disease progression. Patients alive without disease progression are censored at the date of last disease evaluation. Progressive disease (PD) based on RECIST 1.1 is at least a 20% increase in the sum of longest diameter (LD) of target lesions taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions. Equivocal progression of non-target lesions also qualifies as PD.
Objective response rate (ORR)
The ORR will be defined as the proportion of patients in the Efficacy Evaluable patient Set who achieve complete response (CR) and partial response (PR)
Disease control rate (DCR)
The DCR will be defined as the proportion of patients in the Efficacy Evaluable patient Set who achieve complete response (CR) or partial response (PR) or stable disease (SD).
Overall survival(OS)
OS, defined as the time from the date of informed consent until to the date of death, regardless of the cause of death.
Incidence of Treatment-Emergent Adverse Events (Safety)
All the treatment-related adverse events occurred as assessed by CTCAE v4.0
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