Letrozole and Palbociclib in Advanced Breast Cancer: Outcome from Cancer Institute, Chennai

Gnanaguru, Vijay; Dhanushkodi, Manikandan; Radhakrishnan, Venkatraman; Kalaiyarasi, Jayachandran Perumal; Mehra, Nikita; Joshi, Archit; Rajan, Arun; Selvarajan, Gangothri; Karunakaran, Parathan; Ananthi, Balasubramanian; Iyer, Priya; Senguttuvan, Geetha; Rao, Manjula; Priya, M. Krishna; Sridevi, V.; Raj, Hemanth; Ranganathan, Rama; Sundersingh, Shirley; Kumar, Kiran; Ganesarajah, Selvaluxmy; Ganesan, Trivadi S.; Sagar, Tenali Gnana

doi:10.4103/ijmpo.ijmpo_156_19

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…The median age of our population was 53 years, comparable to what has been reported in other real-world studies from India [6,7]. This reflects that breast cancer occurs at a younger age in India, with many presenting in an advanced stage.…”

Section: Discussionsupporting

confidence: 85%

“…Dose interruption and modification were less compared to the landmark clinical trials due to inherent bias in underreporting of toxicities in retrospective studies. Permanent discontinuation of the therapy was done in 2.1% of the population, which is almost comparable to retrospective studies [7]. Incidence of febrile neutropenia was less than the study by Rath et al [9].…”

Section: Discussionsupporting

confidence: 63%

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Efficacy of cyclin-dependent kinase 4/6 inhibitors in patients with metastatic hormone positive breast cancer: a single institutional study from India

Ganguly¹,

Mukherjee²,

Mandal³

et al. 2022

ecancer

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Purpose: Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors have shown marked benefit in the treatment of hormone positive metastatic breast cancer (HR+ MBC). There are limited real-world studies with palbociclib and ribociclib. Here we report our experience with CDK4/6 inhibitors in these groups of patients.Material and methods: Patients with HR+ MBC who have received either palbociclib or ribociclib during the course of their treatment from January 2017 to January 2022 were included in the study. The baseline demographic features, treatment details and toxicity were recorded. Patients who received at least 1 month of therapy were included in the survival analysis.Results: A total of 144 patients received CDK4/6 inhibitors during the time period. The median age of the population was 53 (30-80) years. Ninety-eight (71.4%) patients presented with de novo metastatic disease. The most common site of metastasis was to the skeleton (74.2%). Most patients (75%) received palbociclib as their therapy. At a median follow-up of 20.2 months, the median progression free survival (PFS) of the whole population was 16.5 (95% confidence interval (95% CI): 11.6-25.5) months and the median overall survival (OS) was 29.7 (95% CI: 21.7-44.6) months. The presence of liver metastases, low progesterone receptor positivity (Allred score < 6) and prior systemic treatment were poor prognostic factors for both PFS and OS in multivariate analysis. Drug was discontinued for only 2.1% of the patient population.Conclusions: Use of CDK4/6 inhibitors has led to improvement in PFS and OS in patients with HR+ MBC and it is well tolerated. The presence of liver metastases and low progesterone receptor positivity (Allred score < 6) and prior treatment are poor prognostic factors.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 63%

Efficacy of cyclin-dependent kinase 4/6 inhibitors in patients with metastatic hormone positive breast cancer: a single institutional study from India

Ganguly¹,

Mukherjee²,

Mandal³

et al. 2022

ecancer

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Letrozole/palbociclib

2020

Reactions Weekly

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Multicentric real world evidence with palbociclib in hormone positive HER2 negative metastatic breast cancer in Indian population

Agrawal

Goyal

Agarwal

et al. 2021

Sci Rep

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The combination of cyclin dependent kinase 4/6 inhibitors with endocrine therapy is the standard therapy in hormone receptor positive HER-2 negative metastatic breast cancer (HR+/HER2− MBC). Several randomized trials have shown the benefits of this combination, however, real world evidence in the Indian patients is warranted. The present study reports the largest real world multicentric data from Indian population on the use of Palbociclib in HR+/HER2− MBC. A multicentric study on the HR+/HER2− MBC patients who received palbociclib with hormonal agent (Aromatase inhibitors/Fulvestrant) between February 2017 and May 2020 was conducted. Clinical and demographic information and survival data was retrieved from the Hospital medical records. Among a total of 188 patients, 57% patients were premenopausal and 17% patients had bone only disease. Altogether, 115 (61%) patients received palbociclib with Aromatase inhibitors in the first line whereas 73 (39%) patients received it in the second line with Fulvestrant. The median follow up period with advanced disease was 13 months. The median progression free survival in the first line and second line was 20.2 months and 12 months, respectively (p-value < 0.0001). The objective response rate was 80% and 47.9% in first and second lines, respectively. Dose interruptions/ discontinuation were done in 14.9% and 2.7% patients in the first and second lines, respectively. In terms of toxicity, 10% patients had grade 3–4 adverse events. The present real world data of the use of palbociclib in Indian population suggests similar effectiveness to previously published real world evidences and has been adapted as the standard of care in the first and second line treatment of HR+/HER2− MBC.

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Letrozole and Palbociclib in Advanced Breast Cancer: Outcome from Cancer Institute, Chennai

Cited by 3 publications

References 24 publications

Efficacy of cyclin-dependent kinase 4/6 inhibitors in patients with metastatic hormone positive breast cancer: a single institutional study from India

Efficacy of cyclin-dependent kinase 4/6 inhibitors in patients with metastatic hormone positive breast cancer: a single institutional study from India

Letrozole/palbociclib

Multicentric real world evidence with palbociclib in hormone positive HER2 negative metastatic breast cancer in Indian population

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