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CDK4/6 VTE Risk — SCE Medical Oncology MCQ

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ModerateBreast CancerCDK4/6 VTE RiskSCE Medical Oncology

A 60-year-old woman with ER+/HER2- breast cancer on CDK4/6 inhibitor develops VTE (DVT). CDK4/6 inhibitors increase VTE risk. What is the approximate VTE incidence with CDK4/6 inhibitors?

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Correct answer: D — Approximately 5-8% — CDK4/6 inhibitors (all three) increase VTE risk approximately 2-fold compared with endocrine therapy alone

All three CDK4/6 inhibitors increase VTE risk (~5-8% vs ~2-4% with ET alone), representing approximately 2-fold elevation. The mechanism is unclear but may involve effects on megakaryocyte function and coagulation cascades. Prophylactic anticoagulation is NOT routinely recommended, but awareness of this risk is important for prompt diagnosis and treatment. VTE management follows standard cancer-associated VTE guidelines (LMWH or DOAC). CDK4/6 inhibitor can often be continued with concurrent anticoagulation.

Reference: ESMO 2024 MBC; MONARCH/MONALEESA/PALOMA safety data; NICE TA495/596/810