256P - Efficacy of palbociclib plus fulvestrant in advanced Hormone Receptor-positive (HR+) Metastatic Breast Cancer (MBC) pretreated with everolimus: rea...

Date 11 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Anti-Cancer Agents & Biologic Therapy
Breast Cancer, Metastatic
Breast Cancer
Presenter Pauline Du Rusquec
Citation Annals of Oncology (2017) 28 (suppl_5): v74-v108. 10.1093/annonc/mdx365
Authors P. Du Rusquec1, C. Palpacuer2, L. Campion2, A. Patsouris3, P. Augereau3, C. Gourmelon1, M. Robert1, L. Dumas4, C. Folliard5, M. Campone1, J. Frenel1
  • 1Medical Oncology, Centre Rene Gauducheau, 44800 - Nantes/FR
  • 2Biostatistics, Centre Rene Gauducheau, 44800 - Nantes/FR
  • 3Medical Oncology, Centre Paul Papin, 49100 - Angers/FR
  • 4Pharmacy, Centre Rene Gauducheau, 44800 - Nantes/FR
  • 5Pharmacy, Centre Paul Papin, 49100 - Angers/FR

Abstract

Background

The CDK4-6 inhibitor palbociclib, combined with hormonal therapy is a new standard of treatment for HR+ Metastatic Breast Cancer. Before the European Medicines Agency approval, a Temporary Authorization for Use (TAU) has been set up in France restricted to patients pretreated with everolimus. We present the efficacy data of this combination in this population.

Methods

Between November 2015 and November 2016, all the patients treated with palbociclib + fulvestrant according to the TAU in our institution were prospectively included. Datas from their medical records and adverse events (AE) were collected.

Results

60 patients received at least one dose of palbociclib in combination with fulvestrant with a median age of 61 years. 50 patients (83.3%) had visceral metastasis and 10 (16.7%) had bone only disease. Patients had received an average of 5.3 lines of treatment before palbociclib initiation, including hormonal therapy (mean = 3.0) and chemotherapy (mean = 2.3). Of note, 28 patients (46.7%) had received fulvestrant previously and all had been pretreated with everolimus. With a median follow-up of 8.1 months, median progression free survival (PFS) was 6.1 months (95% CI, 4.2 to 7.4) and median overall survival was not reached. PFS was the same according to the presence of visceral metastasis or no (HR 1.46 (95% CI, 0.57 to 3.74), p = 0.42). Interestingly, patients treated previously with fulvestrant and subsequently re-challenged with fulvestrant and palbociclib had a PFS of 6.4 months, which was similar to patients who didn’t receive fulvestrant previously (HR = 1.00 (95% CI 0.55 to 1.83), p = 1.00). The most common AE were neutropenia (n = 53), thrombocytopenia (n = 25) and anemia (n = 20). At the time of this analysis (April 2017), 36 patients received a further line of treatment after progression.

Conclusions

In this heavily pretreated population, the association of fulvestrant plus palbociclib provides an interesting median PFS of 6.1 months. Patients previously treated with fulvestrant seem to derive the same magnitude of benefit compared to fulvestrant naive patients.

Clinical trial identification

Legal entity responsible for the study

Institut de Cancérologie de l'Ouest

Funding

None

Disclosure

All authors have declared no conflicts of interest.