EVERGREEN quasi-experimental study

The optimal treatment sequence for patients with ER+/HER2- advanced breast cancer who progress after a CDK4/6 inhibitors (CDK4/6) remains subject to debate. A commonly used treatment for these patients consists of everolimus, but the clinical basis for this approach is limited. To fill up this data gap, the quasi-experimental EVERGEEN study specifically evaluated the comparative effectiveness and safety of EVE vs. ET alone after progression on CDK4/6i.

In this video, Dr Guilherme Nader-Marta (Dana Farber Cancer Institute, Boston, MA, USA) summarizes the key take-aways from this study.

EVERGREEN was a multicentre, international, retrospective, quasi-experimental study including women with ER+/HER2- advanced breast cancer who started next line of therapy after progression on CDK4/6i with either everolimus (N=150) or ET alone (N=57) in sites where everolimus was not standard of care in this setting. After a median follow-up of 31.8 months, the real-world PFS (rwPFS) of patients treated with everolimus was reported at 5.0 months, which was 0.7 months longer than the 4.3 months median rwPFS seen with ET alone (HR[95%CI]: 0.75[0.55-1.02]). A further subgroup analysis learned that the benefit of everolimus over ET alone was more pronounced in patients with a higher body mass index, in patients with a ductal tumour histology, in patients with a longer duration of prior CDK4/6 inhibitor therapy. In addition, a numerically higher magnitude of benefit was also seen in patients with PIK3CA-AKT1-PTEN pathway alterations. No notable safety issues emerged.