{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:32:47Z","timestamp":1789086767428,"version":"build-2803163510"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T00:00:00Z","timestamp":1692144000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T00:00:00Z","timestamp":1692144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Breast Cancer Res Treat"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>ER+\/HER2-\u00a0advanced breast cancer (ABC) with visceral crisis (VC) or impending VC (IVC) is commonly treated with chemotherapy instead of CDK4\/6 inhibitors (CDK4\/6i). However, there is little evidence to confirm which treatment is superior. This study compared outcomes of patients with ER+\/HER2-\u00a0ABC and IVC\/VC treated with CDK4\/6i or weekly paclitaxel.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Patients with ER+\/HER2-\u00a0ABC receiving first line treatment at a large tertiary UK cancer centre from 1-Mar-2017 to 30-Jun-2021 were retrospectively identified. Hospital records were screened for IVC\/VC affecting the liver, lungs\/mediastinum, gastrointestinal tract and\/or bone marrow. Baseline demographics, clinical data and survival outcomes were recorded up to 30-Jul-2022.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>27\/396 (6.8%) patients with ABC who received CDK4\/6i and 32\/86 (37.2%) who received paclitaxel had IVC\/VC. Median time to treatment failure (TTF), progression-free survival (PFS) and overall survival (OS) were significantly longer in the CDK4\/6i compared to paclitaxel cohort: TTF 17.3 vs. 3.5\u00a0months (HR 0.33, 95%CI 0.17\u20130.61, <jats:italic>p<\/jats:italic>\u2009=\u20090.0002), PFS 17.8 vs. 4.5\u00a0months (HR 0.38, 95%CI 0.21\u20130.67, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), OS 24.6 vs. 6.7\u00a0months (HR 0.37, 95%CI 0.20\u20130.68, <jats:italic>p<\/jats:italic>\u2009=\u20090.002). The median time to first improvement in IVC\/VC was similar in patients receiving CDK4\/6i compared to paclitaxel (3.9 vs. 3.6\u00a0weeks, <jats:italic>p<\/jats:italic>\u2009=\u20090.773). Disease control at 4\u00a0months was not significantly different in the CDK4\/6i and paclitaxel cohorts (77.8% vs. 59.4%, <jats:italic>p<\/jats:italic>\u2009=\u20090.168). In multivariate analysis, treatment with CDK4\/6i was independently associated with a longer PFS compared to paclitaxel (HR 0.31, 95%CI 0.12\u20130.78, <jats:italic>p<\/jats:italic>\u2009=\u20090.015).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In this retrospective study, patients with ER+\/HER2- ABC and IVC\/VC treated with CDK4\/6i had a significantly better survival compared to those treated with weekly paclitaxel. Further prospective studies that minimise possible selection bias are recommended.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10549-023-07035-6","type":"journal-article","created":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T06:02:21Z","timestamp":1692165741000},"page":"83-95","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["CDK4\/6 inhibitors versus weekly paclitaxel for treatment of ER+\/HER2-\u00a0advanced breast cancer with impending or established visceral crisis"],"prefix":"10.1007","volume":"202","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1978-6539","authenticated-orcid":false,"given":"Roya","family":"Behrouzi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne C.","family":"Armstrong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sacha J.","family":"Howell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,8,16]]},"reference":[{"key":"7035_CR1","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1200\/JCO.2022.40.17_suppl.LBA1003","volume":"40","author":"RS Finn","year":"2022","unstructured":"Finn RS, Rugo HS, Dieras VC, Harbeck N, Im S-A, Gelmon KA, Walshe JM, Martin M, Chavez Mac Gregor M, Bananis E, Gauthier ER, Lu DR, Kim S, Slamon DJ (2022) Overall survival (OS) with first-line palbociclib plus letrozole (PAL+LET) versus placebo plus letrozole (PBO+LET) in women with estrogen receptor\u2013positive\/human epidermal growth factor receptor 2\u2013negative advanced breast cancer (ER+\/HER2\u2212 ABC). JCO 40:1003\u20131003. https:\/\/doi.org\/10.1200\/JCO.2022.40.17_suppl.LBA1003","journal-title":"JCO"},{"key":"7035_CR2","doi-asserted-by":"publisher","first-page":"S1384","DOI":"10.1016\/j.annonc.2022.08.009","volume":"33","author":"MP Goetz","year":"2022","unstructured":"Goetz MP, Toi M, Huober J, Sohn J, Tredan O, Park IH, Campone M, Chen SC, Sanchez LMM, Paluch-Shimon S, van Hal G, Shahir A, Iwata H, Johnston S (2022) LBA15 MONARCH 3: Interim overall survival (OS) results of abemaciclib plus a nonsteroidal aromatase inhibitor (NSAI) in patients (pts) with HR+, HER2-advanced breast cancer (ABC). Ann Oncol 33:S1384. https:\/\/doi.org\/10.1016\/j.annonc.2022.08.009","journal-title":"Ann Oncol"},{"key":"7035_CR3","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1056\/NEJMoa2114663","volume":"386","author":"GN Hortobagyi","year":"2022","unstructured":"Hortobagyi GN, Stemmer SM, Burris HA, Yap Y-S, Sonke GS, Hart L, Campone M, Petrakova K, Winer EP, Janni W, Conte P, Cameron DA, Andr\u00e9 F, Arteaga CL, Zarate JP, Chakravartty A, Taran T, Le Gac F, Serra P, O\u2019Shaughnessy J (2022) Overall survival with ribociclib plus letrozole in advanced breast cancer. N Engl J Med 386:942\u2013950. https:\/\/doi.org\/10.1056\/NEJMoa2114663","journal-title":"N Engl J Med"},{"key":"7035_CR4","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1093\/annonc\/mdx797","volume":"29","author":"NC Turner","year":"2018","unstructured":"Turner NC, Finn RS, Martin M, Im S-A, DeMichele A, Ettl J, Di\u00e9ras V, Moulder S, Lipatov O, Colleoni M, Cristofanilli M, Lu DR, Mori A, Giorgetti C, Iyer S, Bartlett CH, Gelmon KA (2018) Clinical considerations of the role of palbociclib in the management of advanced breast cancer patients with and without visceral metastases. Ann Oncol 29:669\u2013680. https:\/\/doi.org\/10.1093\/annonc\/mdx797","journal-title":"Ann Oncol"},{"key":"7035_CR5","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1038\/s41523-021-00222-y","volume":"7","author":"JFR Robertson","year":"2021","unstructured":"Robertson JFR, Di Leo A, Johnston S, Chia S, Bliss JM, Paridaens RJ, Lichfield J, Bradbury I, Campbell C (2021) Meta-analyses of visceral versus non-visceral metastatic hormone receptor-positive breast cancer treated by endocrine monotherapies. NPJ Breast Cancer 7:11. https:\/\/doi.org\/10.1038\/s41523-021-00222-y","journal-title":"NPJ Breast Cancer"},{"key":"7035_CR6","doi-asserted-by":"publisher","first-page":"1623","DOI":"10.1016\/j.annonc.2020.09.010","volume":"31","author":"F Cardoso","year":"2020","unstructured":"Cardoso F, Paluch-Shimon S, Senkus E, Curigliano G, Aapro MS, Andr\u00e9 F, Barrios CH, Bergh J, Bhattacharyya GS, Biganzoli L, Boyle F, Cardoso M-J, Carey LA, Cort\u00e9s J, Saghir NSE, Elzayat M, Eniu A, Fallowfield L, Francis PA, Gelmon K, Gligorov J, Haidinger R, Harbeck N, Hu X, Kaufman B, Kaur R, Kiely BE, Kim S-B, Lin NU, Mertz SA, Neciosup S, Offersen BV, Ohno S, Pagani O, Prat A, Penault-Llorca F, Rugo HS, Sledge GW, Thomssen C, Vorobiof DA, Wiseman T, Xu B, Norton L, Costa A, Winer EP (2020) 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5). Ann Oncol 31:1623\u20131649. https:\/\/doi.org\/10.1016\/j.annonc.2020.09.010","journal-title":"Ann Oncol"},{"key":"7035_CR7","doi-asserted-by":"publisher","first-page":"105","DOI":"10.14740\/wjon1043w","volume":"8","author":"Y Sbitti","year":"2017","unstructured":"Sbitti Y, Slimani K, Debbagh A, Mokhlis A, Kadiri H, Laraqui A, Errihani H, Ichou M (2017) Visceral crisis means short survival among patients with luminal a metastatic breast cancer: a retrospective cohort study. World J Oncol 8:105\u2013109. https:\/\/doi.org\/10.14740\/wjon1043w","journal-title":"World J Oncol"},{"key":"7035_CR8","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.breast.2021.03.002","volume":"57","author":"MA Franzoi","year":"2021","unstructured":"Franzoi MA, Sa\u00fade-Conde R, Ferreira SC, Eiger D, Awada A, de Azambuja E (2021) Clinical outcomes of platinum-based chemotherapy in patients with advanced breast cancer: an 11-year single institutional experience. Breast 57:86\u201394. https:\/\/doi.org\/10.1016\/j.breast.2021.03.002","journal-title":"Breast"},{"key":"7035_CR9","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.breast.2021.04.001","volume":"58","author":"C Funasaka","year":"2021","unstructured":"Funasaka C, Naito Y, Kusuhara S, Nakao T, Fukasawa Y, Mamishin K, Komuro A, Okunaka M, Kondoh C, Harano K, Kogawa T, Matsubara N, Hosono A, Kawasaki T, Mukohara T (2021) The efficacy and safety of paclitaxel plus bevacizumab therapy in breast cancer patients with visceral crisis. Breast 58:50\u201356. https:\/\/doi.org\/10.1016\/j.breast.2021.04.001","journal-title":"Breast"},{"key":"7035_CR10","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1200\/JCO.2021.39.15_suppl.1047","volume":"39","author":"SS Dawood","year":"2021","unstructured":"Dawood SS, Brzozowski K (2021) Efficacy of CDK4\/6i in the visceral crisis setting: result from a real-world database. JCO 39:1047\u20131047. https:\/\/doi.org\/10.1200\/JCO.2021.39.15_suppl.1047","journal-title":"JCO"},{"key":"7035_CR11","doi-asserted-by":"publisher","first-page":"1048781","DOI":"10.3389\/fonc.2022.1048781","volume":"12","author":"R Yang","year":"2022","unstructured":"Yang R, Lu G, Lv Z, Jia L, Cui J (2022) Different treatment regimens in breast cancer visceral crisis: a retrospective cohort study. Front Oncol 12:1048781. https:\/\/doi.org\/10.3389\/fonc.2022.1048781","journal-title":"Front Oncol"},{"key":"7035_CR12","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1016\/j.ejca.2008.10.026","volume":"45","author":"EA Eisenhauer","year":"2009","unstructured":"Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J (2009) New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 45:228\u2013247. https:\/\/doi.org\/10.1016\/j.ejca.2008.10.026","journal-title":"Eur J Cancer"}],"container-title":["Breast Cancer Research and Treatment"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10549-023-07035-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10549-023-07035-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10549-023-07035-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T05:14:08Z","timestamp":1694754848000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10549-023-07035-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,16]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["7035"],"URL":"https:\/\/doi.org\/10.1007\/s10549-023-07035-6","relation":{},"ISSN":["0167-6806","1573-7217"],"issn-type":[{"value":"0167-6806","type":"print"},{"value":"1573-7217","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,16]]},"assertion":[{"value":"19 May 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 July 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 August 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"RB: No competing interests to declare. ACA: Spousal shares in Astra Zeneca; Honoraria for advisory boards for MSD, Gilead and Astra Zeneca; Conference fees and travel expenses from Novartis; Research funding from Astra Zeneca paid to institution. SJH: Honoraria for speaking engagements for Pfizer, Novartis and Lilly; Honoraria for advisory boards for Lilly; Joint working agreement with Lilly and Novartis.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This study was approved as a service evaluation project by the Quality Improvement and Clinical Audit Committee at The Christie NHS Foundation Trust, Manchester, UK on 21-Jun-2021 (Reference Number 22\/3030). Service evaluations are exempt from ethics application in the UK according to Human Research Authority guidance.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}