57P Benefit of CDK4/6 inhibitors beyond PIK3CA mutations in metastatic breast cancer patients

Ortega, Paul; Cejalvo, Juan Miguel; Terencio, S. Moragon; Carril-Ajuria, Lucía; Bermejo, Begoña; Ruíz, A.; Melia, C. Hernando; Sánchez-Torre, A.; Martínez, María Teresa; Herrera, Marta; Gambardella, Valentina; Lema, Laura; Roda, Desamparados; Bernal, Elsa; Rentero-Garrido, Pilar; Lluch, Aña; Ciruelos, Eva; Manso, Luís

doi:10.1016/j.annonc.2020.03.191

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“…However, among patients who progressed on first‐line endocrine treatment in less than 6 months, the prevalence of PIK3CA mutations was higher (46.67%). These patients exhibited primary endocrine resistance 23 . In our research, 26 individuals progressed less than six months of endocrine therapy, and we did not notice a statistically significant difference in the proportion of patients with primary endocrine resistance between PIK3CA mutated and WT patients.…”

Section: Discussioncontrasting

confidence: 48%

“…These patients exhibited primary endocrine resistance. 23 In our research, 26 individuals progressed less than six months of endocrine therapy, and we did not notice a statistically significant difference in the proportion of patients with primary endocrine resistance between PIK3CA mutated and WT patients. In addition, we noticed that the mutations were present in individuals with metastatic illness at the time of diagnosis, suggesting that the existence of PIK3CA muts is indicative of a more aggressive disease in these patients.…”

Section: Discussionmentioning

confidence: 47%

“…However, among patients who progressed on first-line endocrine treatment in less than 6 months, the prevalence of PIK3CA mutations was higher (46.67%). These patients exhibited primary endocrine resistance 23. In our research, 26 individuals progressed less F I G U R E 4 Kaplan-Maier estimates of overall survival (OS).…”

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confidence: 72%

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Prevalence and prognosis of PIK3CA mutations in Bulgarian patients with metastatic breast cancer receiving endocrine therapy in first‐line setting

Gencheva,

Petrova,

Kraleva

et al. 2023

Cancer Reports

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Background and aimsIn approximately 40% of patients with HER2‐negative/HR‐positive breast cancer tumors, the PIK3CA gene is mutated. Despite this, clinical outcomes vary between studies in this cohort. We aimed to ascertain the prevalence of PIK3CA mutations in patients with metastatic HR+/HER2– breast in Bulgaria, as well the evaluation and comparison of progression free survival (PFS) between wild‐type (WT) and mutation‐positive groups in the real‐world setting.MethodsThree oncology centers in Bulgaria collected 250 tissue samples between 2016 and 2022 for this multicentric retrospective study. PIK3CA mutations were identified using Real‐Time qPCR. The median follow‐up period was 35 months.ResultsThe mean age of the mutant cohort was 57.6 ± 11.6 years, compared to 56.5 ± 12.2 years for the WT cohort (p = .52). The percentage of patients with visceral metastasis was 58.8% (n = 147). Approximately 84.3% (n = 210) of the patients had reached postmenopause. 29.2% (n = 73) of the patients had PIK3CA mutations. The predominant mutation was present in exon 20, H1047R (46.5%). We found a significant correlation only between the presence of a mutation and the metastatic diseases at diagnosis (p = .002). As first‐line therapy, 67.1% of patients received endocrine therapy (ET) plus cyclin dependent kinase (CDK4/6) inhibitor, while the remainder received ET alone. The median PFS of patients in the group with the mutation was 32 months (95%, CI: 22–40) compared to 24 months in the WT cohort ((95%, CI: 21–36) (p = .45)); HR = 0.86 (95%, CI: 0.5–1.3) (p = .46). We corroborated our conclusion using propensity matching score analysis, (36 months [95% CI: 20–40] vs. 26 months [95% CI: 21–38], [p = .69]).ConclusionsWe found that the prevalence of PIK3CA mutations in our patients was comparable to what has been reported in other nations. Our results suggest that PIK3CA mutational status has no bearing to ET efficacy in first‐line setting.

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Section: Discussioncontrasting

confidence: 48%

Section: Discussionmentioning

confidence: 47%