Armando Orlandi Evaluates CDK4/6 Inhibitors in Adjuvant Breast Cancer Using NNT Metric
Armando Orlandi, Medical Director at the Agostino Gemelli University Hospital Foundation IRCCS, shared a post on LinkedIn:
“CDK4/6 Inhibitors in Adjuvant Setting: A Number Needed to Treat Perspective
My recent publication in Journal of Cancer Research and Clinical Oncology has reignited the debate on CDK4/6 inhibitors use in adjuvant breast cancer treatment.
The Data Speaks Volumes
When analyzing efficacy through Number Needed to Treat (NNT):• Abemaciclib (monarchE): NNT = 16 (6.4% absolute benefit at 4 years)
• Ribociclib (NATALEE): NNT = 20 (4.9% absolute benefit at 4 years)Comparing with Established Therapies
These results compare favorably with:• Aromatase Inhibitors vs Tamoxifen: NNT = 29
• Adjuvant Chemotherapy (ER+): NNT = 10-14
• Trastuzumab: NNT = 9The Path Forward
Rather than categorical rejection, we should focus on:
- Identifying high-risk subgroups most likely to benefit
- Adaptive dosing protocols to optimize risk-benefit ratio
- Predictive biomarkers for more precise patient selection
- Proactive toxicity management strategies
Reflection
The evolution of cancer treatment has always involved passionate debate. Adjuvant chemotherapy, extended endocrine therapy, and trastuzumab all faced initial skepticism.
Scientific progress emerges from critical discourse, not from categorical dismissal.”
Read the full article.
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