Palbociclib Induced Neutropenia; Risk Factors and Treatment Outcome in Metastatic Breast Cancer Patients

NCT ID: NCT06076772

Last Updated: 2023-10-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Total Enrollment

54 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-11-30

Study Completion Date

2026-12-31

Brief Summary

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Aim of the study to assess the neutropenia induced by Palbociclib in patient receiving Palbociclib in combination with hormonal treatment as first-line therapy in metastatic hormone receptor- positive HER2 negative breast cancer. To evaluate the risk factors for occurrence of neutropenia and treatment outcome as 2 years PFS and OS.

Detailed Description

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Palbociclib is an orally active cyclin-dependent kinase (CDK) and is considered the standard treatment for hormone receptor (HR)-positive, (HER) negative metastatic breast cancer.

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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Metastatic Breast Cancer

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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1

cases developed neutropenia Grade 0-2 with palbociclib administration

Palbociclib

Intervention Type DRUG

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

Intervention Type DRUG

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

Intervention Type DRUG

Other Intervention Names

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Other drugs (hormonal treatment)+ denosumab

Eligibility Criteria

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Inclusion Criteria

* Histological pathological confirmation of primary breast cancer or metastatic disease.
* 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

* Patient with co-morbidity
* Pregnant and breast lactating women
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Asmaa I Mekkawy

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Asmaa Imam Ahmed

Al Madīnah, AL, Saudi Arabia

Site Status

Countries

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Saudi Arabia

Central Contacts

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Asmaa I Ahmed, Master

Role: CONTACT

01065751145

Hanan G Mostafa, MD

Role: CONTACT

01004082002

Facility Contacts

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Asmaa I Ahmed

Role: primary

0562059896

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.

Reference Type BACKGROUND
PMID: 37054718 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 32641862 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 36260177 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 34625634 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 37345147 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 33820647 (View on PubMed)

Other Identifiers

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Palbociclib

Identifier Type: -

Identifier Source: org_study_id

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