Overall Survival With Palbociclib And Fulvestrant in Women With HR+/HER2– ABC: Updated Exploratory Analyses of PALOMA-3, a Double-Blind, Phase 3 Randomized Study

Cristofanilli, Massimo and Rugo, Hope S. and Im, Seock-Ah and Slamon, Dennis J. and Harbeck, Nadia and Bondarenko, Igor and Masuda, Norikazu and Colleoni, Marco and DeMichele, Angela and Loi, Sherene and Iwata, Hiroji and O’Leary, Ben and André, Fabrice and Loibl, Sibylle and Bananis, Eustratios and Liu, Yuan and Huang, Xin and Sindy Kim, Sindy Kim and Frean, Maria Jose Lechuga and Turner, Nicholas C. (2022) Overall Survival With Palbociclib And Fulvestrant in Women With HR+/HER2– ABC: Updated Exploratory Analyses of PALOMA-3, a Double-Blind, Phase 3 Randomized Study. Clinical Cancer Research, 28 (16). pp. 3433-3442. ISSN 1078-0432 (print), 1557-3265 ( online)

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Abstract

Purpose: To conduct an updated exploratory analysis of overall survival (OS) with a longer median follow-up of 73.3 months and evaluate the prognostic value of molecular analysis by circulating tumor DNA (ctDNA). Patients and methods: Patients with hormone receptor−positive/human epidermal growth factor receptor 2−negative (HR+/HER2−) advanced breast cancer (ABC) were randomized 2:1 to receive palbociclib (125 mg orally/d; 3/1 week schedule) and fulvestrant (500 mg intramuscularly) or placebo and fulvestrant. This OS analysis was performed when 75% of enrolled patients died (393 events in 521 randomized patients). ctDNA analysis was performed among patients who provided consent. Results: At the data cutoff (August 17, 2020), 258 and 135 deaths occurred in the palbociclib and placebo groups, respectively. The median OS (95% CI) was 34.8 months (28.8−39.9) in the palbociclib group and 28.0 months (23.5−33.8) in the placebo group (stratified hazard ratio 0.81; 95% CI, 0.65−0.99). The 6-year OS rate (95% CI) was 19.1% (14.9−23.7) and 12.9% (8.0−19.1) in the palbociclib and placebo groups, respectively. Favorable OS with palbociclib plus fulvestrant compared with placebo plus fulvestrant was observed in most subgroups, particularly in patients with endocrine-sensitive disease, no prior chemotherapy for ABC, low circulating tumor fraction, and regardless of ESR1, PIK3CA, or TP53 mutation status. No new safety signals were identified. Conclusions: The clinically meaningful improvement in OS associated with palbociclib plus fulvestrant was maintained with >6 years of follow-up in patients with HR+/HER2− ABC, supporting palbociclib plus fulvestrant as a standard of care in these patients. Trial Registration: ClinicalTrials.gov Identifer: NCT01942135

Item Type: Article
Additional Information: https://doi.org/10.1158/1078-0432.CCR-22-0305 Идентификационный номерWOS:000843625200001 (Hybrid Gold Open Access) Идентификатор PubMed35552673 https://www.scopus.com/record/display.uri?eid=2-s2.0-85136342162&origin=SingleRecordEmailAlert&dgcid=raven_sc_search_ru_ru_email&txGid=030f46618e2fe692c92460180a12d819
Uncontrolled Keywords: palbociclib; overall survival; HR+/HER2− advanced breast cancer; ctDNA; CDK4/6 inhibitors
Subjects: Oncology
Divisions: Departments > Department of Oncology and Medical Radiology
Depositing User: Елена Шрамко
Date Deposited: 08 Sep 2022 10:56
Last Modified: 08 Sep 2022 12:25
URI: http://repo.dma.dp.ua/id/eprint/7825

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