Abstract
I want to congratulate Martin and his colleagues for their article [ [1] Martín M. Zielinski C. Ruiz-Borrego M. et al. Overall survival with palbociclib plus endocrine therapy versus capecitabine in postmenopausal patients with hormone receptor-positive, HER2-negative metastatic breast cancer in the PEARL study. Eur J Cancer. 2022; 168: 12-24 Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar ], in which they have evaluated overall survival (OS) with palbociclib plus endocrine therapy (ET) versus capecitabine in postmenopausal patients with hormone receptor-positive, HER2-negative metastatic breast cancer (MBC) in the PEARL study. They have reported that palbociclib plus ET did not show a statistically superior OS compared to capecitabine in MBC patients progressing on aromatase inhibitors. I have two concerns about this great study. First, one of the stratifications was performed according to visceral/non-visceral metastases. Specifically, the visceral metastatic burden was not described. It would be expected that tumours with a higher visceral tumour burden are less likely to be responsive to treatment. Second, weak estrogen receptor status (close similarity to triple-negative breast cancer) has not been reported. These tumours seem to be more likely to be responsive to capecitabine than the palbociclib combination. These two factors might affect the outcome and deserve further investigation. Overall survival with palbociclib plus endocrine therapy versus capecitabine in postmenopausal patients with hormone receptor-positive, HER2-negative metastatic breast cancer in the PEARL studyEuropean Journal of CancerVol. 168PreviewAn earlier analysis of the PEARL phase III study showed that palbociclib plus endocrine therapy (ET) does not improve progression-free survival (PFS) over capecitabine in aromatase inhibitor-resistant, hormone receptor-positive/human epidermal growth factor receptor 2-negative metastatic breast cancer (MBC) patients. Here, we report the final overall survival (OS) analysis. Full-Text PDF Open Access
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