HR+ mBCa: palbociclib similarly effective in geriatric patients

  • Clifton K & al.
  • Breast Cancer Res Treat
  • 5 mar. 2019

  • de Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Geriatric patients (≥70 years old) given the oral CDK4/6 inhibitor palbociclib for hormone receptor (HR)-positive metastatic breast cancer (mBCa) display no differences in common toxicities or PFS vs younger patients.

Why this matters

  • Although >40% of newly diagnosed patients with mBCa are ≥70 years old; geriatric patients are often excluded from clinical trials.
  • This is the first cohort study to address the gap, and was conducted in a real-world setting.
  • Findings are reassuring, given that palbociclib+aromatase inhibitor is becoming the frontline standard of care for HR+ mBCa.

Study design

  • Retrospective cohort of 605 patients at MD Anderson Cancer Center with HR+ mBCa; 92 were aged ≥70 years and 160 were aged ≥65 years.
  • Funding: National Cancer Institute.

Key results

  • Patients ≥70 years had more dose reductions (22.8% vs 8.0% of younger patients had 2 dose reductions; P<.0001 and dose delays vs p than younger patients.>
  • Patients ≥70 years (vs younger counterparts) had no differences in PFS in multivariate analysis or in common palbociclib toxicities (including neutropenic fever, infections, or hospitalizations because of infections).  
    • Older patients had a higher comorbidity index, and these common toxicities may be unrelated to those driving palbociclib dose reductions/delays. 

Limitations

  • Single-center study.
  • Observational design.