Evidence map›Paper›PMID 39851969›Full record

SynthesisCurrent oncology (Toronto, Ont.)2025

Systematic Review and Network Meta-Analysis on Treating Hormone Receptor-Positive Metastatic Breast Cancer After CDK4/6 Inhibitors.

Neha Pathak, Abhenil Mittal, Sudhir Kumar, Chitrakshi Nagpal, Eitan Amir, Partha Haldar, Bharath B Gangadharaiah, Akash Kumar, Ashutosh Mishra, Atul Batra

Abstract readNetwork Meta-AnalysisSystematic Review
In one paragraph

Synthesis in Current oncology (Toronto, Ont.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Neha PathakDivision of Medical Oncology & Hematology, Department of Medicine, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada.
Abhenil MittalHealth Sciences North, Northern Ontario School of Medicine (NOSM U), Sudbury, ON P3E 5J1, Canada.
Sudhir KumarDepartment of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada.
Chitrakshi NagpalDepartment of Medical Oncology, All India Institute of Medical Sciences, New Delhi 110029, India.ORCID 0000-0002-7352-2446
Eitan AmirDivision of Medical Oncology & Hematology, Department of Medicine, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada.ORCID 0000-0002-3706-525X
Partha HaldarCentre for Community Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
Bharath B GangadharaiahDepartment of Medical Oncology, All India Institute of Medical Sciences, New Delhi 110029, India.
Akash KumarDepartment of Medical Oncology, All India Institute of Medical Sciences, New Delhi 110029, India.
Ashutosh MishraDepartment of Surgical Oncology, All India Institute of Medical Sciences, New Delhi 110029, India.ORCID 0000-0002-5390-5482
Atul BatraDepartment of Medical Oncology, All India Institute of Medical Sciences, New Delhi 110029, India.ORCID 0000-0002-1934-8408

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe optimal treatment of estrogen receptor-positive (ER +) metastatic breast cancer (MBC) after progression on cyclin-dependent 4/6 kinase inhibitors (CDK4/6i) is unknown.

methodsWe conducted a systematic review and network meta-analysis (NMA) of phase-II/-III randomized trials of ER + MBC post CDK4/6i + ET progression. We calculated the hazard ratio (HR) for progression-free survival (PFS) and overall survival (OS) using generic inverse variance and odds ratios (ORs) using the Mantel-Haenszel method for adverse events (AEs) with Review-Manager version-5.4. NMA was executed using WINBUGS (Microsoft Excel). Three molecular subgroups were analyzed: HER2-low, PI3K/AKT/mTOR, and the ESR1 mutation subgroup for selective estrogen receptor degrader (SERD).

resultsA total of 14 studies were included. In the HER2-low group, Sacituzumab govitecan and trastuzumab deruxtecan had a similar efficacy (HR, 95% CI): PFS (0.98; 0.63-1.43) and OS (1.08; 0.76-1.55). In PI3K/AKT/mTOR-altered cases, capivasertib was superior to alpelisib PFS (0.77; 0.53-1.12), and OS (0.80; 0.48-1.35). SERDs had worse PFS and OS versus ongoing CDK 4/6i (ribociclib).

conclusionNo therapy emerged as the unequivocal choice in the post-CDK 4/6i domain in unselected subgroups. In the HER2-low population, a similar efficacy and different toxicity spectrum was seen. In AKT-altered tumors, capivasertib was less toxic than alpelisib. PROSPERO ID: CRD4202236412.

Indexed as

Breast NeoplasmsCyclin-Dependent Kinase 4Cyclin-Dependent Kinase 6Protein Kinase InhibitorsErb-b2 Receptor Tyrosine KinasesFemaleHumansNeoplasm MetastasisReceptors, EstrogenCDK4 protein, humanCDK6 protein, humanCyclin-Dependent Kinase 4Cyclin-Dependent Kinase 6Erb-b2 Receptor Tyrosine KinasesProtein Kinase InhibitorsReceptors, EstrogenAKT inhibitorCDK4/6 inhibitorHER2-low breast cancerhormone receptor-positive cancermetastatic breast cancerSERD

Identifiers

PMID39851969
PMCPMC11763720

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.