Clinical comprehensive evaluation of CDK4/6 inhibitor combined with aromatase inhibitors drugs for first-line treatment for patients with HR+/HER2- advanced breast cancer
Objective To compare the clinical comprehensive value of CDK4/6 inhibitors palbociclib,ribociclib,and abemaciclib in combination with aromatase inhibitors(AIs)as first-line treatment for patients with HR+/HER2-advanced breast cancer,and to provide reference for clinical medication use.Methods According to"Clinical Comprehensive Evaluation Technical Guidelines for Antineoplastic Drugs(2022 Trial Version)",a clinical comprehensive evaluation system for CDK4/6 inhibitors in combination with AIs for first-line treatment of HR+/HER2-advanced breast cancer was established with network meta-analysis,expert consultation,and other methods.Results The clinical comprehensive evaluation showed that in terms of safety,the overall incidence of adverse reactions of palbociclib,ribociclib,and abemaciclib in combination with AIs was similar,but abemaciclib in combination with AIs had the lowest incidence of adverse reactions(grade 3 or above).In terms of efficacy,there was no significant difference among the three treatment regimens concerning progression-free survival and overall survival.As to cost-effectiveness,the treatment cost of abemaciclib was slightly lower than that of palbociclib.In terms of innovation,abemaciclib had more diverse drug administration methods and target mechanisms,while palbociclib had the lowest patent value but could promote domestic technology.As for suitability,abemaciclib had a broader indication and coverage in the medical insurance catalog,while palbociclib had more diverse drug formulations,and ribociclib had relatively poor suitability.In terms of accessibility,abemaciclib had better availability and affordability compared to palbociclib,and ribociclib was not yet available in China,thus poor accessibility.Conclusion Overall,abemaciclib demonstrates good performance in all six dimensions,with better clinical comprehensiveness than that of palbociclib and ribociclib.Appropriate drugs should based on patients'baseline characteristics in clinical practice.
comprehensive clinical evaluationCDK4/6 inhibitoraromatase inhibitorbreast cancer
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