Abstract
Palbociclib in combination with endocrine therapy increases progression-free survival in patients with ER-positive, HER2-negative advanced breast cancer (BC). In this study, we retrospectively evaluated safety in the first patient treated with concurrent use of palbociclib and radiation therapy (RT) in the Curie Institute. Between April 2017 and August 2019, 30 women with metastatic BC received locoregional and/or symptomatic irradiation at a metastatic site concurrently with palbociclib. The most common acute toxicities were radiodermatitis and neutropenia. Palbociclib had to be discontinued during RT in three locally treated patients who developed grade 3 radiodermatitis and febrile neutropenia, grade 2 dysphagia and metastatic disease progression, respectively. After a follow-up of at least 6 months, none of the patients had late toxicity. Concomitant administration of palbociclib with RT was reasonably well tolerated in our series of 30 patients. More prospective data with longer follow-up are needed to confirm these results.
Highlights
In the recent PALOMA-2 and PALOMA-3 clinical trials, addition of palbociclib, a CDK4/6 inhibitor, to standard endocrine therapy significantly improved outcomes in treatment of ER-positive, HER2-negative advanced breast cancer (BC).[1,2] the risks associated with concomitant combination of palbociclib and radiation therapy (RT) are unknown, and the majority of radiation and medical oncologists prefer to suspend palbociclib during RT
In 2017, Hans et al, in a short letter, reported the very preliminary results in five patients treated with this combination.[3]
External beam RT was administered for bone metastases to a total dose of 20 Gy in five fractions, whereas the fifth patient underwent stereotactic body RT for liver metastases to a total dose of 60 Gy in ten fractions
Summary
In the recent PALOMA-2 and PALOMA-3 clinical trials, addition of palbociclib, a CDK4/6 inhibitor, to standard endocrine therapy significantly improved outcomes in treatment of ER-positive, HER2-negative advanced breast cancer (BC).[1,2] the risks associated with concomitant combination of palbociclib and radiation therapy (RT) are unknown, and the majority of radiation and medical oncologists prefer to suspend palbociclib during RT. The objective of this study was to retrospectively assess toxicity in a large number of patients treated with a combination of palbociclib and RT (Palbo-RT)
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