Eficácia de Inibidores de Cdk’s na Sobrevida Livre de Progressão da Doença de Pacientes Com Câncer de Mama Avançado Rh+/her2-: Uma Revisão Sistemática

Abstract

Breast cancer (BC) is the most prevalent type of cancer and the second leading cause of death in women. The RH positive and HER2 negative subtype is the most common, corresponding to about 70% of diagnosed cases. A critical pathway in these types of neoplasia is the cyclin-dependent kinases (CDKs) pathway, which have a regulatory aspect within cell division, especially the CDK 4/6 enzymes. In this way, drugs were created that inhibit this route, which appear with good results in the survival of the metastatic disease. Therefore, the aim of the study was to determine the effectiveness of treatment with CDK inhibitors on progression-free survival and overall survival of patients with RH+/HER2- metastatic breast cancer. This is a systematic review of the literature based on the norms of the PRISMA guideline (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). Among the 2871 studies identified through the descriptors in the databases used, 8 were included in the final sample of the study after analysis by the inclusion and exclusion criteria. As a result, 4 studies showed that therapy with a CDK inhibitor showed higher rates of disease progression-free survival compared to placebo, 2 studies showed that there was no statistical difference between groups and another 2 did not perform a comparative analysis, although they did show a higher survival rate than with other types of treatment. The CDK inhibitor used in 7 of the 8 studies was palbociclib and there were no serious adverse events that would question the risk-benefit ratio of the class. It is noteworthy that the Brazilian Ministry of Health already recommends the use of these drugs for women with advanced breast cancer. It is concluded, therefore, that the class is effective for the purpose assigned and that it can be used safely in the public, providing higher rates of disease progression-free survival.