S. Bose (Wolverhampton, United Kingdom)
Author Of 1 Presentation
115P - Palbociclib-Letrozole in advanced breast cancer - a real world review from a regional cancer centre in the United Kingdom.
Abstract
Background
Hormone receptor-positive breast cancer represents the largest therapeutic subtype in breast cancer, accounting for almost 60-65% of the cases. CDK 4/6 inhibitors, in combination with Letrozole, have changed the therapeutic landscape in advanced hormone-positive breast cancers in terms of improved outcomes with a manageable toxicity profile.We report our experience using this combination in our patients with metastatic hormone-positive breast cancers.
Methods
We analyzed our patients who were diagnosed with hormone-positive metastatic breast cancers and treated with Palbociclib-Letrozole from June 2017 to December 2019. We stratified the patients based on demographic characteristics, performance status, site and number of metastases, and line of treatment. Our primary endpoint was to collect PFS and toxicity profiles.
Results
At a median follow-up of 14.5 months, the median PFS in all the 73 treated patients was 27.5 months (95% CI 23.7-31.2 months; p 0.004).The most common toxicities were neutropenia ( 65.8% all grade,21 % Grade 3 and 15% Grade 4), fatigue (29% grade 3),oral mucositis (30.1%),arthralgia(24.7%).There were 5 patients who needed admission (2 with febrile neutropenia,1 with dehydration and AKI, 1 with hypercalcemia, and 1 with diarrhea). Permanent discontinuation was done in 6 patients due to toxicity, and 36 patients required dose reduction due to neutropenia.
Patient characteristics N=73 Median age, years 64(39–88) ECOG performance status 0 1 2 8 (11) 51(70) 14 (19) Disease setting -De novo metastatic -Recurrent metastatic 33(45.2) 40(54.8) Metastatic site -Bone only -Visceral only -Bone and visceral 21 (28.8) 16 (21.9) 36 (49.3) Number of organ sites -One -Multiple 26 (35.6) 47 (64.4)
Conclusions
In our cohort of patients, we found out that treatment with Palbociclib plus Letrozole resulted in a median PFS of 27.5 months, and 29.4 months when used as upfront. However, the tolerability in our patients seems to be better, with lesser rates of Grade 3/ 4 toxicities (especially myelotoxicity), lesser dose reductions, and a very small number of patients needing treatment discontinuation. This is of paramount importance especially during the current pandemic situation, where we need to balance treatment delivery and immune-suppression to achieve optimal outcomes.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Presenter Of 1 Presentation
115P - Palbociclib-Letrozole in advanced breast cancer - a real world review from a regional cancer centre in the United Kingdom.
Abstract
Background
Hormone receptor-positive breast cancer represents the largest therapeutic subtype in breast cancer, accounting for almost 60-65% of the cases. CDK 4/6 inhibitors, in combination with Letrozole, have changed the therapeutic landscape in advanced hormone-positive breast cancers in terms of improved outcomes with a manageable toxicity profile.We report our experience using this combination in our patients with metastatic hormone-positive breast cancers.
Methods
We analyzed our patients who were diagnosed with hormone-positive metastatic breast cancers and treated with Palbociclib-Letrozole from June 2017 to December 2019. We stratified the patients based on demographic characteristics, performance status, site and number of metastases, and line of treatment. Our primary endpoint was to collect PFS and toxicity profiles.
Results
At a median follow-up of 14.5 months, the median PFS in all the 73 treated patients was 27.5 months (95% CI 23.7-31.2 months; p 0.004).The most common toxicities were neutropenia ( 65.8% all grade,21 % Grade 3 and 15% Grade 4), fatigue (29% grade 3),oral mucositis (30.1%),arthralgia(24.7%).There were 5 patients who needed admission (2 with febrile neutropenia,1 with dehydration and AKI, 1 with hypercalcemia, and 1 with diarrhea). Permanent discontinuation was done in 6 patients due to toxicity, and 36 patients required dose reduction due to neutropenia.
Patient characteristics N=73 Median age, years 64(39–88) ECOG performance status 0 1 2 8 (11) 51(70) 14 (19) Disease setting -De novo metastatic -Recurrent metastatic 33(45.2) 40(54.8) Metastatic site -Bone only -Visceral only -Bone and visceral 21 (28.8) 16 (21.9) 36 (49.3) Number of organ sites -One -Multiple 26 (35.6) 47 (64.4)
Conclusions
In our cohort of patients, we found out that treatment with Palbociclib plus Letrozole resulted in a median PFS of 27.5 months, and 29.4 months when used as upfront. However, the tolerability in our patients seems to be better, with lesser rates of Grade 3/ 4 toxicities (especially myelotoxicity), lesser dose reductions, and a very small number of patients needing treatment discontinuation. This is of paramount importance especially during the current pandemic situation, where we need to balance treatment delivery and immune-suppression to achieve optimal outcomes.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.