Palbociclib combined with endocrine therapy in heavily pretreated HR +/HER2 - advanced breast cancer patients: results from the compassionate use program in Spain (PALBOCOMP)

Manso, Luis; Servitja Tormo, Sonia; Moreno, Fernando

doi:http://dx.doi.org/10.1016/j.breast.2020.11.005

Palbociclib combined with endocrine therapy in heavily pretreated HR +/HER2 - advanced breast cancer patients: results from the compassionate use program in Spain (PALBOCOMP)

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Manso L, Hernando C, Galán M, Oliveira M, Cabrera MA, Bratos R, et al. Palbociclib combined with endocrine therapy in heavily pretreated HR +/HER2 - advanced breast cancer patients: results from the compassionate use program in Spain (PALBOCOMP). Breast. 2020 Dec; 54: 286-92. DOI: 10.1016/j.breast.2020.11.005

Abstract

Background: This study evaluated efficacy and safety of palbociclib, a CDK4/6 inhibitor, in heavily-pretreated hormone receptor-positive and human epidermal growth factor receptor 2-negative (HR+/HER2-) metastatic breast cancer (mBC) patients during the compassionate use program in Spain from February 2015 to November 2017. Patients and methods: Patient data were collected retrospectively from 35 hospitals in Spain. Patients with HR+/HER2- mBC who had progressed on ≥4 treatments for advanced disease were eligible. Results: A total of 219 patients received palbociclib in combination with aromatase inhibitors (110; 50.2%), fulvestrant (87; 39.7%), tamoxifen (8; 3.6%) or as single agent (10; 4.6%). Mean age of the patients was 58 years; 31 patients (16.1%) were premenopausal and 162 (83.9%) were postmenopausal at the beginning of treatment with palbociclib. Patients had received a median of 3 previous lines of endocrine therapy (ET) for advanced disease. Real-world tumor response (rwTR) and clinical benefit rate were 5.9% (n = 13) and 46.2% (n = 101), respectively. The median real world progression-free survival (rwPFS) was 6.0 months (95% CI 5.7-7.0) and the median overall survival was 19.0 months (95% CI 16.4-21.7). Subgroup analysis revealed a significant difference in median rwPFS in patients treated with palbociclib plus fulvestrant depending on the duration of prior treatment with fulvestrant monotherapy (>6 versus ≤6 months; HR 1.93, 95% CI 1.37-2.73, p < 0.001). The most frequently reported toxicities were neutropenia, asthenia, thrombopenia and anemia. Conclusions: Palbociclib can be an effective and safe treatment option in patients with heavily pretreated endocrine-sensitive mBC, especially in those with longer PFS to previous ET.