TY - JOUR
T1 - Efficacy of Palbociclib Combinations in Hormone Receptor–Positive Metastatic Breast Cancer Patients After Prior Everolimus Treatment
AU - Dhakal, Ajay
AU - Matthews, Christina M.
AU - Levine, Ellis Glenn
AU - Salerno, Kilian Elizabeth
AU - Zhang, Fan
AU - Takabe, Kazuaki
AU - Early, Amy P.
AU - Edge, Stephen B.
AU - O'Connor, Tracy
AU - Khoury, Thaer
AU - Young, Jessica S.
AU - Opyrchal, Mateusz
N1 - Publisher Copyright:
© 2018 The Authors
PY - 2018/12
Y1 - 2018/12
N2 - This retrospective study examined outcomes of hormone receptor-positive (HR + ) human epidermal growth factor receptor 2 nonamplified (HER2 − ) metastatic breast cancer (MBC) in patients with prior exposure to everolimus on palbociclib-based therapy. Twenty-three eligible patients with HR + HER2 − MBC were assessed. Median progression-free survival (PFS) was 2.9 months (95% confidence interval, 2.1-4.2), objective response rate (ORR) 0 (0%) of 23 and clinical benefit rate (CBR) of 4 (17.4%) of 23. We found a limited clinical activity of palbociclib combinations after progression of disease in patients receiving everolimus combination. Purpose: Outcome data on hormone receptor positive (HR + ), human epidermal growth factor receptor 2 (HER2) nonamplified (HER2 − ) metastatic breast cancer (MBC) treated with palbociclib after treatment with everolimus are lacking. The PALOMA-3 trial, showing benefit of palbociclib plus fulvestrant compared to fulvestrant alone in HR + HER2 − MBC after progression while receiving endocrine therapy excluded women previously treated with everolimus. The objective of this study was to examine outcomes of HR + HER2 − MBC with prior exposure to everolimus while receiving palbociclib-based therapy. Patients and Methods: A retrospective, single-institute review was conducted of HR + HER2 − MBC from January 2014 to November 2016 in patients treated with palbociclib after prior treatment with everolimus. Progression-free survival (PFS) was defined as the time from initiation of palbociclib to the date of progression as determined by the treating physician based on radiologic, biochemical, and/or clinical criteria. Response rates were determined on the basis of available radiologic data. Objective response rate (ORR) was defined as the rate of any complete or partial responses; clinical benefit rate (CBR) was the rate of complete response, partial response, or stable disease for at least 24 weeks. Results: Twenty-three patients with a mean (range) age of 68 (42-81) years were identified. Kaplan-Meier estimate showed median PFS of 2.9 months (95% confidence interval, 2.1-4.2); ORR was 0 of 23 and CBR was 4 (17.4%) of 23. In the PALOMA-3 trial, median PFS, ORR, and CBR of palbociclib cohort were 9.5 months (95% confidence interval, 9.2-11.0), 19%, and 67%, respectively. Conclusion: There is a limited clinical activity of palbociclib combinations after progression with everolimus combination therapy. Further studies are necessary to confirm these findings.
AB - This retrospective study examined outcomes of hormone receptor-positive (HR + ) human epidermal growth factor receptor 2 nonamplified (HER2 − ) metastatic breast cancer (MBC) in patients with prior exposure to everolimus on palbociclib-based therapy. Twenty-three eligible patients with HR + HER2 − MBC were assessed. Median progression-free survival (PFS) was 2.9 months (95% confidence interval, 2.1-4.2), objective response rate (ORR) 0 (0%) of 23 and clinical benefit rate (CBR) of 4 (17.4%) of 23. We found a limited clinical activity of palbociclib combinations after progression of disease in patients receiving everolimus combination. Purpose: Outcome data on hormone receptor positive (HR + ), human epidermal growth factor receptor 2 (HER2) nonamplified (HER2 − ) metastatic breast cancer (MBC) treated with palbociclib after treatment with everolimus are lacking. The PALOMA-3 trial, showing benefit of palbociclib plus fulvestrant compared to fulvestrant alone in HR + HER2 − MBC after progression while receiving endocrine therapy excluded women previously treated with everolimus. The objective of this study was to examine outcomes of HR + HER2 − MBC with prior exposure to everolimus while receiving palbociclib-based therapy. Patients and Methods: A retrospective, single-institute review was conducted of HR + HER2 − MBC from January 2014 to November 2016 in patients treated with palbociclib after prior treatment with everolimus. Progression-free survival (PFS) was defined as the time from initiation of palbociclib to the date of progression as determined by the treating physician based on radiologic, biochemical, and/or clinical criteria. Response rates were determined on the basis of available radiologic data. Objective response rate (ORR) was defined as the rate of any complete or partial responses; clinical benefit rate (CBR) was the rate of complete response, partial response, or stable disease for at least 24 weeks. Results: Twenty-three patients with a mean (range) age of 68 (42-81) years were identified. Kaplan-Meier estimate showed median PFS of 2.9 months (95% confidence interval, 2.1-4.2); ORR was 0 of 23 and CBR was 4 (17.4%) of 23. In the PALOMA-3 trial, median PFS, ORR, and CBR of palbociclib cohort were 9.5 months (95% confidence interval, 9.2-11.0), 19%, and 67%, respectively. Conclusion: There is a limited clinical activity of palbociclib combinations after progression with everolimus combination therapy. Further studies are necessary to confirm these findings.
KW - CDK 4/6 inhibitor
KW - Endocrine therapy
KW - Resistance to endocrine therapy
KW - Sequential endocrine therapy
KW - mTOR inhibitor
UR - https://www.scopus.com/pages/publications/85047216421
U2 - 10.1016/j.clbc.2018.04.015
DO - 10.1016/j.clbc.2018.04.015
M3 - Article
C2 - 29778787
AN - SCOPUS:85047216421
SN - 1526-8209
VL - 18
SP - e1401-e1405
JO - Clinical breast cancer
JF - Clinical breast cancer
IS - 6
ER -