Palbociclib plus letrozole as treatment for postmenopausal women with hormone receptor–positive/human epidermal growth factor receptor 2–negative advanced breast cancer for whom letrozole therapy is deemed appropriate: An expanded access study in Australia and India

Sherene Loi, Christos S. Karapetis, Nicole McCarthy, Catherine Oakman, Andrew Redfern, Michelle White, Mustafa Khasraw, Dinesh Chandra Doval, Vinod Gore, Mahmood Alam, Justin Binko, Dongrui Ray Lu, Sindy Kim, Frances Boyle

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Abstract

Aim: Palbociclib was approved in the United States in 2015 to treat estrogen receptor–positive/human epidermal growth factor receptor 2–negative (HER2–) advanced breast cancer (ABC). This study evaluated outcomes and safety in patients treated with palbociclib in Australia and India with hormone receptor–positive (HR+)/HER2– ABC before palbociclib became commercially available. Methods: Postmenopausal women (≥18 years) with HR+/HER2– ABC who were appropriate candidates for letrozole therapy received palbociclib 125 mg once daily for 21 days followed by 7 days off, and letrozole 2.5 mg once daily (continuous). Safety, tumor response, and patient-reported outcomes (Australian cohort) were evaluated. Results: In total, 252 patients received palbociclib plus letrozole (Australia, n = 152; India, n = 100). More patients in the Australian versus Indian cohort had received prior chemotherapy (advanced/metastatic setting: 45.9% vs. 32.0%), endocrine therapy (advanced/metastatic setting: 63.2% vs. 54.3%), and advanced/metastatic therapies (61.8% vs. 31.0%). The most frequently reported all-grade palbociclib-related treatment-emergent adverse events were neutropenia (66.7%), fatigue (35.3%), and stomatitis (26.6%); grade 3/4 neutropenia was reported as palbociclib-related in 62.7% of patients. Febrile neutropenia was reported in six patients (2.4%). Eight patients (3.2%) discontinued because of an adverse event. The objective response rate was 19.4% (95% CI, 14.7%–24.9%) overall and 2.3% in Australian patients with ≥2 lines of prior therapy for metastatic disease. Patient-reported quality of life scores were maintained throughout the study. Conclusions: In an expanded access setting in Australia and India, palbociclib plus letrozole was well tolerated in patients with HR+/HER2– ABC, with a safety profile consistent with previous reports.

Original languageEnglish
Pages (from-to)560-569
Number of pages10
JournalAsia-Pacific Journal of Clinical Oncology
Volume18
Issue number6
DOIs
Publication statusPublished - Dec 2022

Keywords

  • advanced breast cancer
  • Australia
  • HR+/HER2–
  • India
  • letrozole
  • palbociclib

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