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Purpose <p>Investigate skeletal morbidity (SM) in metastatic breast cancer (MBC) patients undergoing CDK4/6 inhibitors (CDK4/6is) and endocrine therapy (ET).</p> Methods <p>In this retrospective study we evaluated skeletal morbidity – defined as the occurrence of skeletal-related events (SREs) in metastatic bone and fragility fractures in non-metastatic bone – in 214 MBC patients who had received ET and CDK4/6is. As secondary aim, we compared VF progression, defined as a new fracture or worsening of a pre-existing fracture at spine CT scan, between 121 patients receiving ET alone (cohort A) and 121 patients on ET plus CDK4/6is (cohort B), balanced using propensity score.</p> Results <p>Among the 147 patients (68.7%) with bone metastases, 59 (40.1%) experienced SREs including non-vertebral pathologic fractures (17 patients, 11.6%), pathologic VF progression (21 patients, 14.3%), spinal cord compression (3 patients, 2.0%), radiation to bone (18 patients, 12.2%). Considering the non-metastatic bone, 3 out of 214 patients (1.4%) experienced new non-vertebral fragility fractures, and 26 patients (12.2%) had fragility VF progression. In the comparative study, pathologic VF progression in metastatic bone was 38.3% in cohort A and 29.1% in cohort B (p = 0.093). The corresponding fragility VF progression rate in non-metastatic bone was 22.3% and 12.4% (p = 0.031).</p> Conclusions <p>A considerable proportion of women with MBC treated with CDK4/6is + ET experience SM on both metastatic and non-metastatic bone. Patients treated with CDK4/6is + ET had lower SM than those on ET alone.</p>

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Fracture risk in metastatic breast cancer patients treated with CDK 4/6 inhibitors and endocrine therapy

  • 期刊论文

  • 发表日期：

    2026年1月20日

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  • Rebecca Pedersini,
  • Laura Moretti,
  • Marta Laganà,
  • Greta Schivardi,
  • Valentin Baluta,
  • Manuel Zamparini,
  • Eleonora Conforti,
  • Marco Ravanelli,
  • Caterina Brentegani,
  • Vito Amoroso,
  • Salvatore Grisanti,
  • Chiara Buizza,
  • Giulia Scartabellati,
  • Michela Bazzoli,
  • Giuseppe Ippolito,
  • Federica Pellicioli,
  • Davide Farina,
  • Alfredo Berruti,
  • Deborah Cosentini

摘要

Purpose

Investigate skeletal morbidity (SM) in metastatic breast cancer (MBC) patients undergoing CDK4/6 inhibitors (CDK4/6is) and endocrine therapy (ET).

Methods

In this retrospective study we evaluated skeletal morbidity – defined as the occurrence of skeletal-related events (SREs) in metastatic bone and fragility fractures in non-metastatic bone – in 214 MBC patients who had received ET and CDK4/6is. As secondary aim, we compared VF progression, defined as a new fracture or worsening of a pre-existing fracture at spine CT scan, between 121 patients receiving ET alone (cohort A) and 121 patients on ET plus CDK4/6is (cohort B), balanced using propensity score.

Results

Among the 147 patients (68.7%) with bone metastases, 59 (40.1%) experienced SREs including non-vertebral pathologic fractures (17 patients, 11.6%), pathologic VF progression (21 patients, 14.3%), spinal cord compression (3 patients, 2.0%), radiation to bone (18 patients, 12.2%). Considering the non-metastatic bone, 3 out of 214 patients (1.4%) experienced new non-vertebral fragility fractures, and 26 patients (12.2%) had fragility VF progression. In the comparative study, pathologic VF progression in metastatic bone was 38.3% in cohort A and 29.1% in cohort B (p = 0.093). The corresponding fragility VF progression rate in non-metastatic bone was 22.3% and 12.4% (p = 0.031).

Conclusions

A considerable proportion of women with MBC treated with CDK4/6is + ET experience SM on both metastatic and non-metastatic bone. Patients treated with CDK4/6is + ET had lower SM than those on ET alone.