Palbociclib Induced Neutropenia; Risk Factors and Treatment Outcome in Metastatic Breast Cancer Patients
NCT ID: NCT06076772
Last Updated: 2023-10-11
Study Results
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Basic Information
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NOT_YET_RECRUITING
54 participants
OBSERVATIONAL
2023-11-30
2026-12-31
Brief Summary
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Detailed Description
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The PALOMA studies' showed improvement in progression-free survival (PFS) compared to endocrine therapy alone but a non-significant trend towards improved overall survival (OS).
MONALEESA and MONARCH suggest significantly improved OS with the addition of CDK inhibition.
Neutropenia is considered the dose-limiting and most frequent adverse effect of CDK inhibitors resulting in frequent dose reductions and treatment interruptions that are potentially associated with a lack of efficiency. Grade III/IV neutropenia rates were 62-66% in the PALOMA studies.
Some studies investigated the risk factors for the development of palbociclib-induced neutropenia. One concluded that no concomitant use of statins and high BMI were identified as significant predictors for the development of palbociclib-induced neutropenia. and another study also concluded that low baseline ANC, WBC, PLT, and BSA were associated with early grade III/IV neutropenia.
Regarding treatment outcome, two Phase Two clinical trials concluded that the treatment-related neutropenia in the first two cycles was significantly and independently associated with prolonged PFS, suggesting that neutropenia may be a useful pharmacodynamic marker to guide individualised palbociclib dosing.
However, another study concluded that limited dose modification may lead to longer PFS, without increasing toxicity, than the conventional dose scheme.
A study of variable risk factors and treatment outcomes for palbociclib-induced neutropenia will be useful for careful monitoring leading to adapted therapy.
Conditions
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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1
cases developed neutropenia Grade 0-2 with palbociclib administration
Palbociclib
The investigator will follow the patients after starting treatment to follow and observe the outcome of the treatment side effects and risk factors
2
cases developed neutropenia Grade 3-4 with palbociclib administration
Palbociclib
The investigator will follow the patients after starting treatment to follow and observe the outcome of the treatment side effects and risk factors
Interventions
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Palbociclib
The investigator will follow the patients after starting treatment to follow and observe the outcome of the treatment side effects and risk factors
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Hormonal receptor-positive, HER2 negative.
* Metastatic breast cancer at presentation (Den novo) or recurrent.
* Patients did not receive any previous systemic therapy for metastatic disease.
* Performance status (ECOG) 0-2.
Exclusion Criteria
* Pregnant and breast lactating women
ALL
No
Sponsors
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Assiut University
OTHER
Responsible Party
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Asmaa I Mekkawy
Principal Investigator
Locations
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Asmaa Imam Ahmed
Al Madīnah, AL, Saudi Arabia
Countries
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Central Contacts
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Facility Contacts
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Asmaa I Ahmed
Role: primary
References
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Kim SG, Kim MH, Park S, Kim GM, Kim JH, Kim JY, Park HS, Park S, Park BW, Kim SI, Ji JH, Jeong J, Shin K, Lee J, Kim HD, Jung KH, Sohn J. Efficacy of Limited Dose Modifications for Palbociclib-Related Grade 3 Neutropenia in Hormone Receptor-Positive Metastatic Breast Cancer. Cancer Res Treat. 2023 Oct;55(4):1198-1209. doi: 10.4143/crt.2022.1543. Epub 2023 Apr 11.
McAndrew NP, Dickson MA, Clark AS, Troxel AB, O'Hara MH, Colameco C, Gallager M, Gramlich K, Zafman K, Vaughn D, Schwartz GK, O'Dwyer PJ, DeMichele A. Early treatment-related neutropenia predicts response to palbociclib. Br J Cancer. 2020 Sep;123(6):912-918. doi: 10.1038/s41416-020-0967-7. Epub 2020 Jul 9.
Lavery L, DiSogra K, Lea J, Trufan SJ, Symanowski JT, Roberts A, Moore DC, Heeke A, Pal S. Risk factors associated with palbociclib-induced neutropenia in patients with metastatic breast cancer. Support Care Cancer. 2022 Dec;30(12):9803-9809. doi: 10.1007/s00520-022-07400-z. Epub 2022 Oct 19.
Kanbayashi Y, Sakaguchi K, Ishikawa T, Takayama K, Taguchi T. Predictors for development of palbociclib-induced neutropenia in breast cancer patients as determined by ordered logistic regression analysis. Sci Rep. 2021 Oct 8;11(1):20055. doi: 10.1038/s41598-021-99504-5.
Lee Y, Lee D, Seo I, Chae H, Sim SH, Lee KS, Gwak HS. Risk Factors for Palbociclib-Induced Early Developing Neutropenia in Patients with Hormone Receptor-Positive Metastatic Breast Cancer. Cancers (Basel). 2023 May 18;15(10):2810. doi: 10.3390/cancers15102810.
Vazquez L, Arnaud A, Grenier J, Debourdeau P. [Patients treated with palbociclib and endocrine therapy for metastatic breast cancer: Can we predict the occurrence of severe early hematological toxicity?]. Bull Cancer. 2021 May;108(5):544-552. doi: 10.1016/j.bulcan.2021.01.007. Epub 2021 Apr 2. French.
Other Identifiers
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Palbociclib
Identifier Type: -
Identifier Source: org_study_id
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