Palbociclib use with grade 3 neutropenia in hormone receptor-positive metastatic breast cancer.
Breast Cancer Res Treat
; 183(1): 107-116, 2020 Aug.
Article
em En
| MEDLINE
| ID: mdl-32577940
ABSTRACT
PURPOSE:
Neutropenia is the most common toxicity of CDK4/6 inhibitors, causing frequent dose interruptions. However, CDK4/6 inhibitor-induced neutropenia shows a benign clinical course in contrast to that caused by chemotherapy. Here, we investigated the safety of a new dose scheme for palbociclib, which avoids dose delays or reductions due to afebrile grade 3 neutropenia.METHODS:
A consecutive cohort of ER( +)/HER2( -) advanced breast cancer patients who received palbociclib between 2017 and 2018 was analyzed. The patients were classified into Group 1 (patients who maintained palbociclib dose with afebrile grade 3 neutropenia), Group 2 (patients who experienced any dose modification with afebrile grade 3 neutropenia), and Group 3 (patients without afebrile grade 3 neutropenia). The primary endpoint was febrile neutropenia incidence; other toxicities were compared with those of the PALOMA-2 trial.RESULTS:
Among the 107 patients, 54.2%, 22.4%, and 23.4% were classified into Groups 1, 2, and 3, respectively. There was no febrile neutropenia in Groups 1 and 2 during palbociclib treatment. Group 1 showed higher incidence of thrombocytopenia (all-grade, 32.8%; grade 3-4, 8.6%) than Group 2 and the PALOMA-2 data, but there was no bleeding related to thrombocytopenia. Group 1 showed higher incidence of all-grade non-hematologic adverse events than Group 2; only one grade 3 non-hematologic toxicity was observed in Group 1. There were no treatment-related hospitalizations or deaths in Group 1.CONCLUSIONS:
Thus, omitting palbociclib dose modification with afebrile grade 3 neutropenia is safe and tolerable without febrile neutropenia events. This scheme could be useful to avoid unnecessary reductions in palbociclib doses in future practice.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Piperazinas
/
Piridinas
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Neoplasias da Mama
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Receptores de Estrogênio
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Inibidores de Proteínas Quinases
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Estrogênios
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Neutropenia Febril
/
Proteínas de Neoplasias
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Neoplasias Hormônio-Dependentes
Tipo de estudo:
Clinical_trials
/
Etiology_studies
Limite:
Aged
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Female
/
Humans
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Middle aged
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article