Palbociclib in combination with aromatase inhibitors in patients ≥ 75 years with oestrogen receptor-positive, human epidermal growth factor receptor 2 negative advanced breast cancer: A real-world multicentre UK study

El Badri, Salma, Tahir, Bilal, Balachandran, Kirsty, Bezecny, Pavel, Britton, Fiona, Davies, D. Mark, Desouza, Karen, Dixon, Simon, Hills, Daniel, Moe, Maung, Pigott, Thomas, Proctor, Andrew, Shah, Yatri, Simcock, Richard, Stansfeld, Anna, Synowiec, Alicja, Theodoulou, Marianna, Verrill, Mark, Wadhawan, Anshu, Harper-Wynne, Catherine and Wilson, Caroline 2021. Palbociclib in combination with aromatase inhibitors in patients ≥ 75 years with oestrogen receptor-positive, human epidermal growth factor receptor 2 negative advanced breast cancer: A real-world multicentre UK study. The Breast 60 , pp. 199-205. 10.1016/j.breast.2021.10.010

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Abstract

Background Breast cancer incidence increases with age and real-world data is essential to guide prescribing practices in the older population. The aim of this study was to collect large scale real-world data on tolerability and efficacy of palbociclib + AI in the first line treatment of ER+/HER2-advanced breast cancer in those aged ≥75 years. Methods 14 cancer centres participated in this national UK retrospective study. Patients aged ≥75 years treated with palbociclib + AI in the first line setting were identified. Data included baseline demographics, disease characteristics, toxicities, dose reductions and delays, treatment response and survival data. Multivariable Cox regression was used to assess independent predictors of PFS, OS and toxicities. Results 276 patients met the eligibility criteria. The incidence of febrile neutropenia was low (2.2%). The clinical benefit rate was 87%. 50.7% of patients had dose reductions and 59.3% had dose delays. The 12- and 24- month PFS rates were 75.9% and 64.9%, respectively. The 12- and 24- month OS rates were 85.1% and 74.0%, respectively. Multivariable analysis identified PS, Age-adjusted Charlson Comorbidity Index (ACCI) and number of metastatic sites to be independent predictors of PFS. Dose reductions and delays were not associated with adverse survival outcomes. Baseline ACCI was an independent predictor of development and severity of neutropenia. Conclusion Palbociclib is an effective therapy in the real-world older population and is well-tolerated with low levels of clinically significant toxicities. The use of geriatric and frailty assessments can help guide decision making in these patients.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Medicine
Publisher:	Elsevier
ISSN:	0960-9776
Date of First Compliant Deposit:	4 March 2025
Date of Acceptance:	28 October 2021
Last Modified:	04 Mar 2025 14:43
URI:	https://orca.cardiff.ac.uk/id/eprint/176597

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