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Efficacy of Limited Dose Modifications for Palbociclib-Related Grade 3 Neutropenia in Hormone Receptor-Positive Metastatic Breast Cancer

 Seul-Gi Kim  ;  Min Hwan Kim  ;  Sejung Park  ;  Gun Min Kim  ;  Jee Hung Kim  ;  Jee Ye Kim  ;  Hyung Seok Park  ;  Seho Park  ;  Byeong Woo Park  ;  Seung Il Kim  ;  Jung Hwan Ji  ;  Joon Jeong  ;  Kabsoo Shin  ;  Jieun Lee  ;  Hyung-Don Kim  ;  Kyung Hae Jung  ;  Joohyuk Sohn 
 CANCER RESEARCH AND TREATMENT, Vol.55(4) : 1198-1209, 2023-10 
Journal Title
Issue Date
Antineoplastic Combined Chemotherapy Protocols / therapeutic use ; Breast Neoplasms* / pathology ; Female ; Humans ; Neutropenia* / chemically induced ; Receptor, ErbB-2 / metabolism
Afebrile neutropenia ; Limited dose modification ; Metastatic breast cancer ; Palbociclib ; Progression-free survival
Purpose: Frequent neutropenia hinders uninterrupted palbociclib treatment in patients with hormone receptor (HR)-positive breast cancer. We compared the efficacy outcomes in multicenter cohorts of patients with metastatic breast cancer (mBC) receiving palbociclib following conventional dose modification or limited modified schemes for afebrile grade 3 neutropenia.

Materials and methods: Patients with HR-positive, human epidermal growth factor receptor 2-negative mBC (n=434) receiving palbociclib with letrozole as first-line therapy were analyzed and classified based on neutropenia grade and afebrile grade 3 neutropenia management as follows: group 1 (maintained palbociclib dose, limited scheme), group 2 (dose delay or reduction, conventional scheme), group 3 (no afebrile grade 3 neutropenia event), and group 4 (grade 4 neutropenia event). The primary and secondary endpoints were progression-free survival (PFS) between groups 1 and 2 and PFS, overall survival, and safety profiles among all groups.

Results: During follow-up (median 23.7 months), group 1 (2-year PFS, 67.9%) showed significantly longer PFS than did group 2 (2-year PFS, 55.3%; p=0.036), maintained across all subgroups, and upon adjustment of the factors. Febrile neutropenia occurred in one and two patients of group 1 and group 2, respectively, without mortality.

Conclusion: Limited dose modification for palbociclib-related grade 3 neutropenia may lead to longer PFS, without increasing toxicity, than the conventional dose scheme.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Gun Min(김건민) ORCID logo https://orcid.org/0000-0001-9167-8682
Kim, Min Hwan(김민환) ORCID logo https://orcid.org/0000-0002-1595-6342
Kim, Seul-gi(김슬기) ORCID logo https://orcid.org/0000-0003-1641-4059
Kim, Seung Il(김승일)
Kim, Jee Ye(김지예) ORCID logo https://orcid.org/0000-0003-3936-4410
Kim, Jee Hung(김지형) ORCID logo https://orcid.org/0000-0002-9044-8540
Park, Byeong Woo(박병우) ORCID logo https://orcid.org/0000-0003-1353-2607
Park, Se Ho(박세호) ORCID logo https://orcid.org/0000-0001-8089-2755
Park, Hyung Seok(박형석) ORCID logo https://orcid.org/0000-0001-5322-6036
Sohn, Joo Hyuk(손주혁) ORCID logo https://orcid.org/0000-0002-2303-2764
Jeong, Joon(정준) ORCID logo https://orcid.org/0000-0003-0397-0005
Ji, Junghwan(지정환)
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