Hormonal-Receptors-Positive and HER2-Negative Patients with Metastatic Breast Cancer Treated with First-Line Palbociclib and Hormonal Therapy: Impact of First-Cycle Neutropenia and Dose Reduction on Therapeutic Outcome.


Journal

The breast journal
ISSN: 1524-4741
Titre abrégé: Breast J
Pays: United States
ID NLM: 9505539

Informations de publication

Date de publication:
2023
Historique:
received: 02 10 2022
revised: 30 05 2023
accepted: 14 06 2023
medline: 5 9 2023
pubmed: 4 9 2023
entrez: 4 9 2023
Statut: epublish

Résumé

CDK 4/6 inhibitors with hormonal therapy are the standard first-line therapy in metastatic hormonal receptors (HR)-positive and HER2-negative breast cancer. This study aims to assess the impact of neutropenia with 1st cycle, dose reduction, HER2-low status, and other clinicopathological factors on survival outcomes with the first-line palbociclib and hormonal therapy. We recruited 150 patients who received first-line palbociclib with hormonal therapy. 86% of patients developed 1st cycle neutropenia which was more common in patients with high Ki67. Dose reduction was recorded in 46.7% of patients and it was more common in patients with higher Allred scores (scores 7-8). The median progression-free survival (PFS) of the study group was 22 months. No significant difference was observed in PFS according to the 1st cycle of neutropenia or grade of neutropenia. Similarly, no difference in PFS according to palbociclib dose reduction and HER2 low status was observed. Only the Allred score and having a single site of metastasis had an independent significant relation with PFS. The median overall survival (OS) of the study group was 39 months. No significant difference was observed in OS according to the 1st cycle neutropenia, grade of neutropenia, palbociclib dose reduction, and HER2-low status. Only the Allred score and having a single site of metastasis had an independent significant relation with OS. In addition, no difference was observed in PFS and OS according to ECOG PS (2 vs. 0-1) or menopausal status. No significant impact of the 1st cycle neutropenia, dose reduction, having ECOG PS2, menopausal status, or HER2 low status on survival outcome was observed. Survival outcome was significantly better in patients with single metastatic sites and higher ER-Allred scores.

Sections du résumé

Background
CDK 4/6 inhibitors with hormonal therapy are the standard first-line therapy in metastatic hormonal receptors (HR)-positive and HER2-negative breast cancer. This study aims to assess the impact of neutropenia with 1st cycle, dose reduction, HER2-low status, and other clinicopathological factors on survival outcomes with the first-line palbociclib and hormonal therapy.
Results
We recruited 150 patients who received first-line palbociclib with hormonal therapy. 86% of patients developed 1st cycle neutropenia which was more common in patients with high Ki67. Dose reduction was recorded in 46.7% of patients and it was more common in patients with higher Allred scores (scores 7-8). The median progression-free survival (PFS) of the study group was 22 months. No significant difference was observed in PFS according to the 1st cycle of neutropenia or grade of neutropenia. Similarly, no difference in PFS according to palbociclib dose reduction and HER2 low status was observed. Only the Allred score and having a single site of metastasis had an independent significant relation with PFS. The median overall survival (OS) of the study group was 39 months. No significant difference was observed in OS according to the 1st cycle neutropenia, grade of neutropenia, palbociclib dose reduction, and HER2-low status. Only the Allred score and having a single site of metastasis had an independent significant relation with OS. In addition, no difference was observed in PFS and OS according to ECOG PS (2 vs. 0-1) or menopausal status.
Conclusion
No significant impact of the 1st cycle neutropenia, dose reduction, having ECOG PS2, menopausal status, or HER2 low status on survival outcome was observed. Survival outcome was significantly better in patients with single metastatic sites and higher ER-Allred scores.

Identifiants

pubmed: 37664544
doi: 10.1155/2023/8994954
pmc: PMC10473893
doi:

Substances chimiques

palbociclib G9ZF61LE7G

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

8994954

Informations de copyright

Copyright © 2023 Khaled Abd Elaziz Ahmed Elnaghi et al.

Déclaration de conflit d'intérêts

The authors declare that they have no conflicts of interest.

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Auteurs

Khaled Abd Elaziz Ahmed Elnaghi (KAEA)

Medical Oncology Department, Oncology Center, King Abdullah Medical City, Makkah, Saudi Arabia.
Medical Oncology, Oncology Center, Mansoura University, Mansoura, Egypt.

Hosam Ali Alghanmi (HA)

Medical Oncology Department, Oncology Center, King Abdullah Medical City, Makkah, Saudi Arabia.

Shereef Ahmed Elsamany (SA)

Medical Oncology Department, Oncology Center, King Abdullah Medical City, Makkah, Saudi Arabia.
Medical Oncology, Oncology Center, Mansoura University, Mansoura, Egypt.

Fathia Almarzoki (F)

Medical Oncology Department, Oncology Center, King Abdullah Medical City, Makkah, Saudi Arabia.

Mohamed Elsafty (M)

Medical Oncology Department, Oncology Center, King Abdullah Medical City, Makkah, Saudi Arabia.

Mohammad Jaffal (M)

Department of Pharmacy, King Abdullah Medical City, Makkah, Saudi Arabia.

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Classifications MeSH