[A Multicenter Retrospective Study of Predictors of Duration of Treatment with Palbociclib].

Palbociclib(PAL), which is a small molecule with inhibitory activity against cyclin-dependent kinase 4/6, is used in endocrine combined therapy for the treatment of estrogen receptor(ER)-positive and HER2-negative inoperable and recurrent breast cancer. We retrospectively investigated the factors associated with prolonged treatment in inoperable and recurrent breast cancer in a multicenter study. The median time-to-treatment failure(TTF)after PAL was 5.6 months(0.2-22.5). A total of 28 patients in the fulvestrant(FUL)group and 21 patients in the aromatase inhibitor(AI)group received concomitant endocrine therapy. The median TTF was 2.6 vs 6.7 months(p=0.015)for white blood cell(WBC), 3.7 vs 6.6 months (p=0.021)for neutrophils(Neu), and 2.8 vs 7.5 months(p=0.007)for lymphocytes(Lym). The treatment period tended to be prolonged in the group with higher WBC, Neu, and Lym levels than that of the standard values. The median treatment duration of the FUL group was 7.5 months vs 4.2 months(p=0.162); however, the difference was not statistically significant. The WBC, Neu, and Lym levels upon PAL introduction may be factors affecting the prolonged treatment. Further analysis of the data and further investigation of the prolongation-related factors of PAL treatment period are necessary.

Early administration of durvalumab after chemoradiotherapy increased risk of pneumonitis in patients with locally advanced non-small cell lung cancer.

AIMS: Durvalumab (Durva) administration after chemoradiation therapy (CRT) in locally advanced non-small-cell lung cancer (NSCLC) is the standard of care, associated with relatively prolonged progression-free (PFS) and overall survival. However, pneumonitis occurs in 73.6% of Japanese patients. This retrospective study aimed to identify factors associated with Durva efficacy and safety, specifically, the risk of pneumonitis. METHODS: This study included data from 26 consecutive patients with locally advanced NSCLC who underwent CRT followed by Durva. The rates of adverse events and PFS were examined. RESULTS: The median PFS time was 15.6 months (95% confidence interval [CI]: 8.7-not available). Patients developed pneumonitis of grade 1, 2, 3, and 4 at the rate of 62%, 27%, 12%, and 0%, respectively. The median PFS time was 6.4 months for patients with programmed death ligand 1 (PD-L1) expression level of <50% and not reached for patients with PD-L1 expression level of ≥50% (hazard ratio [HR], 0.19; 95% CI: 0.04-0.89), which was significantly prolonged. The cumulative incidence of pneumonitis grade 2 or above was significantly higher when the time between the last day of thoracic radiotherapy (TRT) and the start of Durva therapy was within 14 days compared to >14 days (HR: 0.19; 95% CI: 0.06-0.59). This association was statistically significant in multivariate analysis. CONCLUSIONS: The initiation of Durva therapy within 14 days after TRT may increase the risk of pneumonitis grade 2 or above. Careful observation and suitable treatment are recommended.