{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T08:25:16Z","timestamp":1786868716579,"version":"build-2736575974"},"reference-count":12,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The long-term survival impact of adding CDK4\/6 inhibitors to adjuvant endocrine therapy for hormone receptor-positive, HER2-negative (HR+\/HER2\u2212) early breast cancer remains a subject of active evaluation. We performed an updated meta-analysis incorporating the mature efficacy and survival data to comprehensively evaluate the therapeutic benefit and safety profile of adjuvant CDK4\/6 inhibitors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and meta-analysis of phase III randomized controlled trials comparing adjuvant CDK4\/6 inhibitors plus endocrine therapy with endocrine therapy alone in patients with HR+\/HER2\u2212 EBC was conducted. The primary outcomes were invasive disease-free survival (IDFS) and overall survival (OS). Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using meta-analytic methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Four phase III randomized trials involving 17,784 patients met the inclusion criteria. In the overall analysis, adjuvant CDK4\/6 inhibition significantly improved IDFS compared with endocrine therapy alone. In the prespecified analysis restricted to monarchE and NATALEE, adjuvant abemaciclib and ribociclib significantly reduced the risk of invasive disease recurrence (pooled HR 0.69, 95% CI 0.63\u20130.76; I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%) and demonstrated a significant overall survival benefit with mature follow-up (pooled HR 0.83, 95% CI 0.73\u20130.94; I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%). In contrast, the palbociclib trials (PALLAS and PENELOPE-B) failed to demonstrate improvements in either IDFS or OS. Treatment with CDK4\/6 inhibitors was associated with a higher incidence of grade \u22653 adverse events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Abemaciclib and ribociclib significantly improve IDFS and are associated with emerging OS benefits in patients with high-risk HR+\/HER2\u2212 early high risk breast cancer, whereas palbociclib has not shown comparable efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10781552261476616","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T14:13:21Z","timestamp":1786630401000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of adjuvant CDK4\/6 inhibitors in hormone receptor\u2013positive, HER2-negative early breast cancer: Updated evidence from a systematic review and meta-analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4956-9551","authenticated-orcid":false,"given":"Wala","family":"Ben Kridis","sequence":"first","affiliation":[{"name":"Habib Bourguiba Hospital University of Sfax"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afef","family":"Khanfir","sequence":"additional","affiliation":[{"name":"Habib Bourguiba Hospital University of Sfax"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.01994"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/17588359231178125"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2025.105858"},{"key":"e_1_3_3_5_2","first-page":"2875","article-title":"MONARCH 3: a randomized, double-blind, placebo-controlled phase III study of abemaciclib in combination with letrozole in patients with HR-positive, HER2-negative breast cancer","volume":"35","author":"Goetz MP","year":"2017","unstructured":"Goetz MP, Toi M, Campone M, et al. MONARCH 3: a randomized, double-blind, placebo-controlled phase III study of abemaciclib in combination with letrozole in patients with HR-positive, HER2-negative breast cancer. J Clin Oncol 2017; 35: 2875\u20132884.","journal-title":"J Clin Oncol"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2025.10.005"},{"key":"e_1_3_3_7_2","first-page":"2","article-title":"Role of CDK4\/6 inhibitors in breast cancer treatment","volume":"22","author":"Wildiers H","year":"2020","unstructured":"Wildiers H, Ades F, Bachelot T, et al. Role of CDK4\/6 inhibitors in breast cancer treatment. Breast Cancer Res 2020; 22: 2.","journal-title":"Breast Cancer Res"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1505270"},{"key":"e_1_3_3_9_2","first-page":"3377","article-title":"A comparison of CDK4\/6 inhibitors in the treatment of HR-positive breast cancer","volume":"35","author":"Sledge GW","year":"2017","unstructured":"Sledge GW, Johnston SRD, Swanton C, et al. A comparison of CDK4\/6 inhibitors in the treatment of HR-positive breast cancer. J Clin Oncol 2017; 35: 3377\u20133384.","journal-title":"J Clin Oncol"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2021.100091"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2024.114192"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2021.07.002"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.24.00886"}],"container-title":["Journal of Oncology Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10781552261476616","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10781552261476616","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10781552261476616","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T07:52:40Z","timestamp":1786866760000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10781552261476616"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":12,"alternative-id":["10.1177\/10781552261476616"],"URL":"https:\/\/doi.org\/10.1177\/10781552261476616","relation":{},"ISSN":["1078-1552","1477-092X"],"issn-type":[{"value":"1078-1552","type":"print"},{"value":"1477-092X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,13]]},"article-number":"10781552261476616"}}