Subscribe to RSS
DOI: 10.4103/ijmpo.ijmpo_156_19
Letrozole and Palbociclib in Advanced Breast Cancer: Outcome from Cancer Institute, Chennai
Financial support and sponsorship Nil.
Abstract
Background: Cyclin-dependent kinase 4/6 inhibitor addition to hormonal therapy has shown to improve the survival of hormone receptor (HR)-positive, HER2-negative advanced breast cancer (ABC). Methods: We retrospectively analyzed untreated patients with HR-positive, HER2-negative ABC, who received letrozole and palbociclib at the Cancer Institute, Chennai, from October 2017 to January 2019. Results: A total of 24 patients were included in this study. The median progression-free survival (PFS) was 18 months, and the median overall survival (OS) had not reached. The 1-year PFS and OS were 73.7% and 89.2%, respectively. The common toxicities were neutropenia and fatigue but none of the patients had febrile neutropenia. Conclusion: Letrozole-Palbociclib is effective with manageable toxicity as the first-line treatment for HR-positive, HER2-negative ABC.
Publication History
Received: 22 July 2019
Accepted: 02 January 2020
Article published online:
23 May 2021
© 2020. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 Countries. CA Cancer J Clin 2018; 68: 394-424
- 2 Nair N, Shet T, Parmar V, Havaldar R, Gupta S, Budrukkar A. et al. Breast cancer in a tertiary cancer center in India – An audit, with outcome analysis. Indian J Cancer 2018; 55: 16-22
- 3 Matutino A, Joy AA, Brezden-Masley C, Chia S, Verma S. Hormone receptor-positive, HER2-negative metastatic breast cancer: Redrawing the lines. Curr Oncol 2018; 25: S131-41
- 4 Osborne CK, Schiff R. Mechanisms of endocrine resistance in breast cancer. Annu Rev Med 2011; 62: 233-47
- 5 AlFakeeh A, Brezden-Masley C. Overcoming endocrine resistance in hormone receptor-positive breast cancer. Curr Oncol 2018; 25: S18-27
- 6 Sedlacek H, Czech J, Naik R, Kaur G, Worland P, Losiewicz M. et al. Flavopiridol (L86 8275 NSC 649890), a new kinase inhibitor for tumor therapy. Int J Oncol 1996; 9: 1143-68
- 7 Tan AR, Yang X, Berman A, Zhai S, Sparreboom A, Parr AL. et al. Phase I trial of the cyclin-dependent kinase inhibitor flavopiridol in combination with docetaxel in patients with metastatic breast cancer. Clin Cancer Res 2004; 10: 5038-47
- 8 DiPippo AJ, Patel NK, Barnett CM. Cyclin-dependent kinase inhibitors for the treatment of breast cancer: Past, present, and future. Pharmacotherapy 2016; 36: 652-67
- 9 Finn RS, Martin M, Rugo HS, Jones S, Im SA, Gelmon K. et al. Palbociclib and letrozole in advanced breast cancer. N Engl J Med 2016; 375: 1925-36
- 10 Hortobagyi GN, Stemmer SM, Burris HA, Yap YS, Sonke GS, Paluch-Shimon S. et al. Ribociclib as first-line therapy for HR-positive, advanced breast cancer. N Engl J Med 2016; 375: 1738-48
- 11 Goetz MP, Toi M, Campone M, Sohn J, Paluch-Shimon S, Huober J. et al. MONARCH 3: Abemaciclib as initial therapy for advanced breast cancer. J Clin Oncol 2017; 35: 3638-46
- 12 Im SA, Lu YS, Bardia A, Harbeck N, Colleoni M, Franke F. et al. Overall survival with ribociclib plus endocrine therapy in breast cancer. N Engl J Med 2019; 381: 307-16
- 13 Winters S, Martin C, Murphy D, Shokar NK. Breast cancer epidemiology, prevention, and screening. Prog Mol Biol Transl Sci 2017; 151: 1-32
- 14 Rauthan A, Patil P, Somashekhar S, Zaveri S. Real-world single centre experience with palbociclib as first line treatment in Indian patients with metastatic breast cancer. J Clin Oncol 2018; 36: e13030
- 15 Perez JE, Machiavelli M, Leone BA, Romero A, Rabinovich MG, Vallejo CT. et al. Bone-only versus visceral-only metastatic pattern in breast cancer: Analysis of 150 patients. A GOCS study. Am J Clin Oncol 1990; 13: 294-8
- 16 Figura NB, Potluri TK, Mohammadi H, Oliver DE, Arrington JA, Robinson TJ. et al. CDK 4/6 inhibitors and stereotactic radiation in the management of hormone receptor positive breast cancer brain metastases. J Neurooncol 2019; 144: 583-9
- 17 Zarbin M. Real Life outcomes vs. clinical trial results. J Ophthalmic Vis Res 2019; 14: 88-92
- 18 Giuliano M, Schettini F, Rognoni C, Milani M, Jerusalem G, Bachelot T. et al. Endocrine treatment versus chemotherapy in postmenopausal women with hormone receptor-positive, HER2-negative, metastatic breast cancer: A systematic review and network meta-analysis. Lancet Oncol 2019; 20: 1360-9
- 19 André F, Ciruelos E, Rubovszky G, Campone M, Loibl S, Rugo HS. et al. Alpelisib for PIK3CA-mutated, hormone receptor-positive advanced breast cancer. N Engl J Med 2019; 380: 1929-40
- 20 Wander SA. et al. A multicenter analysis of abemaciclib after progression on palbociclib in patients (pts) with hormone receptor-positive (HR+)/HER2- metastatic breast cancer (MBC). J Clin Oncol 2019; 37: 1057
- 21 Baselga J, Campone M, Piccart M, Burris 3rd HA, Rugo HS, Sahmoud T. et al. Everolimus in postmenopausal hormone-receptor-positive advanced breast cancer. N Engl J Med 2012; 366: 520-9
- 22 Fang H, Huang D, Yang F, Guan X. Potential biomarkers of CDK4/6 inhibitors in hormone receptor-positive advanced breast cancer. Breast Cancer Res Treat 2018; 168: 287-97
- 23 Del Re M, Bertolini I, Crucitta S, Fontanelli L, Rofi E, De Angelis C. et al. Overexpression of TK1 and CDK9 in plasma-derived exosomes is associated with clinical resistance to CDK4/6 inhibitors in metastatic breast cancer patients. Breast Cancer Res Treat 2019; 178: 57-62
- 24 Finn RS, Liu Y, Zhu Z, Martin M, Rugo HS, Diéras V. et al. Biomarker analyses of response to cyclin-dependent kinase 4/6 inhibition and endocrine therapy in women with treatment-naïve metastatic breast cancer. Clin Cancer Res 2020; 26: 110-21