Z. Tippu (Maidstone, United Kingdom)
Author Of 1 Presentation
107P - CDK4/6i adjustment & tumour response in the COVID-19 era
Abstract
Background
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents a proven risk for adverse outcome for patients with cancer and on SACT. Following national guidance, treatment modifications of SACT including for CDK4/6i were initiated across Kent Oncology Centre (KOC) hospitals. We describe the characteristics and outcomes in those who had treatment suspended.
Methods
Retrospective data was extracted for all patients receiving CDK4/6i therapy across three NHS trusts between January to May 2020.Clinician discretion determined need for dose interruption or reduction (considering disease history, age, co-morbidities and prior cytopaenias).
Results
A total of 196 patients receiving Palbociclib (n = 173), Abemaciclib (n = 19) & Ribociclib (n = 4), were included. Concurrent endocrine therapy (Fulvestrant n= 32; Letrozole n=164) was continued for all patients. If receiving Denosumab, this was stopped in 72.4% (n= 92). 60.2% (n=118) had their CDK4/6i interrupted, with a further 1.53% (n=3), having planned, non-toxicity related, dose reductions. Median cycle number at interruption was 10 (1-34), with the median duration of interruption 84 (6-133) days. The treatment interruption group were significantly older (71.4 vs. 59.4 years; p < 0.01), with 40% (n= 48) having bone only disease. In those who had treatment interrupted, 6.8% (n=8) had radiological progression. 6 had progression at sites of established visceral disease. In those who had progressed, 6 were rechallenged with a CDK4/6i, with 4 having stable disease on a subsequent response assessment. There was no significant difference in the number of cycles received at interruption for those who had progressive vs. stable disease (13.9 vs. 12.7; p> 0.05). At the time of radiological progression, those who had progressed had a significantly longer time off drug (107.8 vs. 81.2 days; p<0.01).
Conclusions
A short interruption of CDK4/6i and continuation of endocrine treatment alone, does not appear to adversely affect tumour response from this data. Continued monitoring of this approach during subsequent pandemic waves is required together with specific outcomes of SARS-CoV-2 in the metastatic breast cancer population to ensure evidence based decision making.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
C. Harper-Wynne: Advisory/Consultancy: Pfizer; Advisory/Consultancy: Lilly; Advisory/Consultancy: Novartis; Advisory/Consultancy: AstraZeneca; Advisory/Consultancy: Roche; Advisory/Consultancy: Genomic Health; Advisory/Consultancy: Myriad; Advisory/Consultancy: Everything Genetic. All other authors have declared no conflicts of interest.
Presenter Of 1 Presentation
107P - CDK4/6i adjustment & tumour response in the COVID-19 era
Abstract
Background
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents a proven risk for adverse outcome for patients with cancer and on SACT. Following national guidance, treatment modifications of SACT including for CDK4/6i were initiated across Kent Oncology Centre (KOC) hospitals. We describe the characteristics and outcomes in those who had treatment suspended.
Methods
Retrospective data was extracted for all patients receiving CDK4/6i therapy across three NHS trusts between January to May 2020.Clinician discretion determined need for dose interruption or reduction (considering disease history, age, co-morbidities and prior cytopaenias).
Results
A total of 196 patients receiving Palbociclib (n = 173), Abemaciclib (n = 19) & Ribociclib (n = 4), were included. Concurrent endocrine therapy (Fulvestrant n= 32; Letrozole n=164) was continued for all patients. If receiving Denosumab, this was stopped in 72.4% (n= 92). 60.2% (n=118) had their CDK4/6i interrupted, with a further 1.53% (n=3), having planned, non-toxicity related, dose reductions. Median cycle number at interruption was 10 (1-34), with the median duration of interruption 84 (6-133) days. The treatment interruption group were significantly older (71.4 vs. 59.4 years; p < 0.01), with 40% (n= 48) having bone only disease. In those who had treatment interrupted, 6.8% (n=8) had radiological progression. 6 had progression at sites of established visceral disease. In those who had progressed, 6 were rechallenged with a CDK4/6i, with 4 having stable disease on a subsequent response assessment. There was no significant difference in the number of cycles received at interruption for those who had progressive vs. stable disease (13.9 vs. 12.7; p> 0.05). At the time of radiological progression, those who had progressed had a significantly longer time off drug (107.8 vs. 81.2 days; p<0.01).
Conclusions
A short interruption of CDK4/6i and continuation of endocrine treatment alone, does not appear to adversely affect tumour response from this data. Continued monitoring of this approach during subsequent pandemic waves is required together with specific outcomes of SARS-CoV-2 in the metastatic breast cancer population to ensure evidence based decision making.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
C. Harper-Wynne: Advisory/Consultancy: Pfizer; Advisory/Consultancy: Lilly; Advisory/Consultancy: Novartis; Advisory/Consultancy: AstraZeneca; Advisory/Consultancy: Roche; Advisory/Consultancy: Genomic Health; Advisory/Consultancy: Myriad; Advisory/Consultancy: Everything Genetic. All other authors have declared no conflicts of interest.