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PROPSEA, safety evaluation of palbociclib and ribociclib in older patients with breast cancer: A prospective real-world TOG study

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SCHOOL OF MEDICINE
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Avci, Okan
Iriagac, Yakup
Cavdar, Eyyuep
Karaboyun, Kubilay
Araz, Murat
Sakalar, Teoman
Degerli, Ezgi
Ozdemir, Ozlem
Inal, Ali
Ocak, Birol

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Introduction: In this study, the toxicities and management of palbociclib and ribociclib in older patients (>= 65 years) with metastatic breast cancer patients were investigated.Materials and Methods: Among older patients receiving palbociclib and ribociclib, Geriatric 8 (G8) and Groningen Frailty Index were used to evaluate frailty status. Dose modifications, drug withdrawal and other serious adverse events (SAEs) were recorded and analyzed according to baseline patient characteristics.Results: A total of 160 patients from 28 centers in Turkey were included (palbociclib = 76, ribociclib = 84). Forty-three patients were >= 75 years of age. The most common cause of first dose modification was neutropenia for both drugs (97% palbociclib, 69% ribociclib). Liver function tests elevation (10%) and renal function impairment (6%) were also causes for ribociclib dose modification. Drug withdrawal rate was 3.9% for palbociclib and 6% for ribociclib. SAEs were seen in 11.8% of those taking palbociclib and 15.5% of those on riboclib. An ECOG performance status of >= 2 and being older than 75 years were associated with dose reductions. Severe neutropenia was more common in patients with non-bone-only metastatic disease, those receiving treatment third-line therapy or higher, coexistance of non-neutropenic hematological side effects (for ribociclib). Neutropenia was less common among patients with obesity.Discussion: Our results show that it can be reasonable to start palbociclib and ribociclib at reduced dose in patients aged >= 75 years and/or with an ECOG performance status >= 2.

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Elsevier

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Oncology, Geriatrics, Gerontology

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Journal of Geriatric Oncology

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10.1016/j.jgo.2023.101604

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