Abstract
Background: Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors, including palbociclib, are approved for treating advanced hormone receptor (HR)-positive/HER2-negative breast cancer. Although these agents are generally safe and effective, their use is associated with high rates of hematological adverse events, particularly neutropenia, compared to hormone therapy alone. Dose reductions and adjustments are recommended for managing these toxicities. We evaluated the neutropenia profiles, dose management of palbociclib, and clinical responses after dose reductions. Methodology: This retrospective study included 93 patients with advanced HR-positive/HER2-negative breast cancer treated with palbociclib and hormone therapy at the Mohammed VI Cancer Center, CHU IBN ROCHD, Casablanca, over three years (January 2021 to December 2023). Results: Ninety-three patients received at least one dose of palbociclib with hormone therapy. The mean patient age was 56 years, and 13 had visceral disease. The frequencies of neutropenia of any grade/grade 3/grade 4 were 81.72%/60.22%/7.53%. Twenty-nine patients required a dose reduction from 125 to 100 mg of palbociclib, and three patients required further reduction to 75 mg. The incidence of neutropenia of any grade and grade 3/4 decreased after dose reduction. No cases of febrile neutropenia or permanent treatment discontinuation were reported. Conclusion: Palbociclib combined with hormone therapy was well tolerated. Neutropenia, the most frequently reported adverse event in women with advanced HR-positive/HER2-negative breast cancer, was primarily transient and manageable through dose adjustments for patients experiencing grade ≥3 neutropenia, without compromising efficacy. Keywords: Advanced breast cancer; Cyclin-dependent kinase; Palbociclib; Neutropenia; Dose reduction.
Published Version
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