Effectiveness and safety of palbociclib and ribociclib as treatment for metastatic breast cancer in a Costa Rican Hospital from 2017 to 2022
Palbociclib y ribociclib en cáncer de mama
DOI:
https://doi.org/10.51481/amc.v66i4.1434Keywords:
Breast neoplasms, Costa Rica, mortality, palbociclib, ribociclibAbstract
Aim: To describe and compare the effectiveness and safety of palbociclib and ribociclib with endocrine therapy as treatment for metastatic breast cancer.
Methods: A cohort study was carried out with all patients employing palbociclib or ribociclib as treatment for hormone receptor positive, human epidermal growth factor receptor 2 negative (HR+/HER2-) breast cancer, during June 2017 and December 2022 at Hospital San Juan de Dios, San José, Costa Rica. A retrospective review was performed to obtain clinical variables from medical files. Progression-free survival (PFS) and overall survival (OS) were calculated through Kaplan-Meier method. The effectiveness and safety outcomes were compared through the log-rank test and chi-squared, respectively.
Results: During the study period a total of 125 patients were identified using palbociclib (n=81), or ribociclib (n=44), as first line (n=98) or subsequent therapy (n=27) for metastatic breast cancer. For patients receiving palbociclib or ribociclib as first-line therapy, median PFS was 23.5 months (95% Confidence Interval (95%CI): 17.3-39.6 months), and median OS was 32.4 months (95% CI: 20.6-61.3 months), with no differences between both therapies (PFS Hazard ratio: 0.68; 95%CI: 0.41-1.16, p=0.15). A total of 13 patients (10.5%) had to reduce treatment dose due to persistent side effects, with hematological adverse reactions as the most frequent side effects (anemia: 35%, neutropenia: 28%).
Conclusions: There were no significant differences between palbociclib and ribociclib with endocrine therapy as first or further lines of therapy for metastatic HR+/HER2- breast cancer.
Downloads
References
1. Loibl S, Poortmans P, Morrow M, Denkert C, Curigliano G. Breast Cancer. 2021. Lancet 397:397:1750-1769. DOI: 10.1016/S0140-6736(20)32381-3
2. Gennari A, André F, Barrios CH, Cortés J, de Azambuja E, DeMichele A, et al. ESMO Clinical Practice Guideline for the diagnosis, staging and treatment of patients with metastatic breast cancer. Ann Oncol 2021; 32:1475-1495. DOI: 10.1016/j.annonc.2021.09.019
3. Scott SC, Lee SS, Abraham J. Mechanisms of therapeutic CDK4/6 inhibition in breast cancer. Seminars Oncol 2017; 44:385-394. DOI: 10.1053/j.seminoncol.2018.01.006
4. Eggersmann T, Deggenhart T, Gluz O, Wuerstlein R,Harbeck N. CDK4/6 inhibitors expand the therapeutic options in breast cancer: Palbociclib, Ribociclib and Abemaciclib. Biodrugs 2019; 33(2): 125-135. DOI: 10.1007/s40259-019-00337-6
5. Finn RS, Martin M, Rugo H, Jones S, Im S, Gelmon K, et al. Palbociclib and Letrozole in Advanced Breast Cancer. N Engl J Med 2016; 375:1925-1936. DOI: 10.1056/NEJMoa1607303
6. Hortobagyi GN, Stemmer SM, Burris HA, Yap Y, Sonke GS, Paluch-Shimon S, et al. Ribociclib as First-Line Therapy for HR-Positive, Advanced Breast Cancer. N Engl J Med 2016; 375:1738-1748. DOI: 10.1056/NEJMoa1609709
7. Turner NC, Slamon DJ, Ro J, Bondarenko I, Im SA, Masuda N, Colleoni M, et al. Overall Survival with Palbociclib and Fulvestrant in Advanced Breast Cancer. N Engl J Med 2018; 379:1926-1936. DOI: 10.1056/NEJMoa1810527
8. Slamon DJ, Neven P, Chia S, Fasching PA, De Laurentis M, Im SA, et al. Overall Survival with Ribociclib plus Fulvestrant in Advanced Breast Cancer. N Engl J Med 2020; 382:514-524. DOI: 10.1056/NEJMoa191114
9. Thomssen C, Lüftner D, Untch M, Haidinger R, Würstlein R, Harbeck N, et al. International Consensus Conference for Advanced Breast Cancer, Lisbon 2019: ABC5 Consensus - Assessment by a German Group of Experts. Breast Care (Basel) 2020; 15:82–95. DOI: 10.1159/000505957
10. Aparicio A, Guzman P, Morera M, Calvo Y, Obando M, Landaverde D, et al. The First Population-Level Description of Women Diagnosed With Invasive Breast Cancer in Costa Rica From 2008 to 2012: A Cross-Sectional Study. Cancer Control 2023; 30. DOI: 10.1177/10732748231193550
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Acta Médica Costarricense
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Los autores que publican en la revista Acta Médica Costarricense pueden distribuir, copiar, remezclar, retocar, leer, descargar, imprimir, buscar y crear a partir de su obra de modo no comercial, indicando los créditos a la revista y sus autores y compartir su obra en las mismas condiciones. Para ello se aplica la licencia Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional(CC BY-NC-SA 4.0)
