CDK4/6-Inhibitoren beim Mammakarzinom

The cyclin-dependent kinase (CDK)4/6 inhibitors palbociclib, ribociclib, and abemaciclib have demonstrated significant improvements in progression-free survival in numerous clinical trials in metastasized hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer. Since palbociclib and ribociclib were approved in Germany, CDK4/6 inhibitors in combination with antihormonal therapy have been a standard treatment in first- and also in second-line therapy. Abemaciclib, the third CDK4/6, inhibitor will be approved in Germany this year. Side effects, particularly neutropenia, are well managed in daily routine by dose reductions and dose interruptions. The necessary intensive treatment monitoring has to be adhered to precisely, in order to administer treatment in the form of a well-tolerated maintenance therapy. Several clinical trials in the neo-/adjuvant setting are currently in progress, in order to transfer the survival advantage from the metastasized situation into early breast cancer. The aim of this article is to elucidate the mode of action, efficacy, and side effects of the CDK4/6 inhibitors, and to put them in a current clinical context.