Palbociclib dose reductions and the effect on clinical outcomes in patients with advanced breast cancer

Background: This study aimed to provide insights into the real-world use of palbociclib, dose reductions, and drug effectiveness in (older) patients with advanced breast cancer (BC). Patients and methods: Patients with advanced BC treated with palbociclib from 2017 to 2020 were included. The Kaplan-...

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Autores principales:	R.K. Ismail, J. van Breeschoten, M.W.J.M. Wouters, M. van Dartel, S. van der Flier, A.K.L. Reyners, P. de Graeff, A.M.G. Pasmooij, A. de Boer, K.E. Broekman, D.L. Hilarius
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Palbociclib Breast cancer Clinical outcomes Dose reductions Older patients Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/8b339da85bf44324a32bf1247266980f
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spelling	oai:doaj.org-article:8b339da85bf44324a32bf1247266980f2021-11-22T04:18:08ZPalbociclib dose reductions and the effect on clinical outcomes in patients with advanced breast cancer1532-308010.1016/j.breast.2021.11.013https://doaj.org/article/8b339da85bf44324a32bf1247266980f2021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S0960977621009954https://doaj.org/toc/1532-3080Background: This study aimed to provide insights into the real-world use of palbociclib, dose reductions, and drug effectiveness in (older) patients with advanced breast cancer (BC). Patients and methods: Patients with advanced BC treated with palbociclib from 2017 to 2020 were included. The Kaplan-Meier method was used to calculate time to next treatment (TTNT) and overall survival (OS) for patients with or without dose reductions. These clinical outcomes were also compared in subgroup analyses for older patients (≥70 years) and younger patients (<70 years) and for patients discontinuing palbociclib early (<4 administrations). Results: A total of 598 patients with advanced BC were included, with a median age of 64 years. Palbociclib dose reductions occurred in 33% of all patients. Early discontinuation of palbociclib without dose reductions occurred in 23% of the patients. Patients who required a palbociclib dose reduction were older (median age 67 years vs. 63 years). Patients with dose reductions had a significantly higher TTNT of 16.9 vs. 11.4 months (p < 0.001) and median OS of 29.7 vs. 21.9 months (p = 0.003) compared to patients without dose reductions. The TTNT in older patients was significantly longer (16.9 vs. 11.6 months, p = 0.013) than younger patients, but OS was similar (20.7 vs. 26.7 months, p = 0.051). Conclusion: Palbociclib dose reductions occurred in real-world practice similarly to the PALOMA-3 trial. Patients with dose reductions had no poorer outcomes compared to patients not requiring a dose reduction. Older patients treated with palbociclib had more frequent dose reductions, but this did not appear to affect OS.R.K. IsmailJ. van BreeschotenM.W.J.M. WoutersM. van DartelS. van der FlierA.K.L. ReynersP. de GraeffA.M.G. PasmooijA. de BoerK.E. BroekmanD.L. HilariusElsevierarticlePalbociclibBreast cancerClinical outcomesDose reductionsOlder patientsNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBreast, Vol 60, Iss , Pp 263-271 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Palbociclib Breast cancer Clinical outcomes Dose reductions Older patients Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Palbociclib Breast cancer Clinical outcomes Dose reductions Older patients Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 R.K. Ismail J. van Breeschoten M.W.J.M. Wouters M. van Dartel S. van der Flier A.K.L. Reyners P. de Graeff A.M.G. Pasmooij A. de Boer K.E. Broekman D.L. Hilarius Palbociclib dose reductions and the effect on clinical outcomes in patients with advanced breast cancer
description	Background: This study aimed to provide insights into the real-world use of palbociclib, dose reductions, and drug effectiveness in (older) patients with advanced breast cancer (BC). Patients and methods: Patients with advanced BC treated with palbociclib from 2017 to 2020 were included. The Kaplan-Meier method was used to calculate time to next treatment (TTNT) and overall survival (OS) for patients with or without dose reductions. These clinical outcomes were also compared in subgroup analyses for older patients (≥70 years) and younger patients (<70 years) and for patients discontinuing palbociclib early (<4 administrations). Results: A total of 598 patients with advanced BC were included, with a median age of 64 years. Palbociclib dose reductions occurred in 33% of all patients. Early discontinuation of palbociclib without dose reductions occurred in 23% of the patients. Patients who required a palbociclib dose reduction were older (median age 67 years vs. 63 years). Patients with dose reductions had a significantly higher TTNT of 16.9 vs. 11.4 months (p < 0.001) and median OS of 29.7 vs. 21.9 months (p = 0.003) compared to patients without dose reductions. The TTNT in older patients was significantly longer (16.9 vs. 11.6 months, p = 0.013) than younger patients, but OS was similar (20.7 vs. 26.7 months, p = 0.051). Conclusion: Palbociclib dose reductions occurred in real-world practice similarly to the PALOMA-3 trial. Patients with dose reductions had no poorer outcomes compared to patients not requiring a dose reduction. Older patients treated with palbociclib had more frequent dose reductions, but this did not appear to affect OS.
format	article
author	R.K. Ismail J. van Breeschoten M.W.J.M. Wouters M. van Dartel S. van der Flier A.K.L. Reyners P. de Graeff A.M.G. Pasmooij A. de Boer K.E. Broekman D.L. Hilarius
author_facet	R.K. Ismail J. van Breeschoten M.W.J.M. Wouters M. van Dartel S. van der Flier A.K.L. Reyners P. de Graeff A.M.G. Pasmooij A. de Boer K.E. Broekman D.L. Hilarius
author_sort	R.K. Ismail
title	Palbociclib dose reductions and the effect on clinical outcomes in patients with advanced breast cancer
title_short	Palbociclib dose reductions and the effect on clinical outcomes in patients with advanced breast cancer
title_full	Palbociclib dose reductions and the effect on clinical outcomes in patients with advanced breast cancer
title_fullStr	Palbociclib dose reductions and the effect on clinical outcomes in patients with advanced breast cancer
title_full_unstemmed	Palbociclib dose reductions and the effect on clinical outcomes in patients with advanced breast cancer
title_sort	palbociclib dose reductions and the effect on clinical outcomes in patients with advanced breast cancer
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/8b339da85bf44324a32bf1247266980f
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Palbociclib dose reductions and the effect on clinical outcomes in patients with advanced breast cancer

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