Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville.
Economic, Social & Administrative Pharmacy, College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee.
J Manag Care Spec Pharm. 2020 Jul;26(7):826-831. doi: 10.18553/jmcp.2020.26.7.826.
Despite the achieved advancement in pharmacological cancer treatments, the majority of postmenopausal women with hormone receptor-positive metastatic breast cancer (mBC) will experience disease progression. Research into alternative therapies with improved efficacy and reduced side effects has led to the development of a new class of oral anticancer medications, the cyclin-dependent kinase (CDK) 4/6 inhibitors, which include palbociclib, ribociclib, and abemaciclib. Nonetheless, there is growing evidence that the effectiveness of oral anticancer medications is sub-optimal, being influenced by low adherence, sociodemographic factors, and adverse effect profiles. In addition, there is a disconnect between the high price tags of CDK 4/6 inhibitors and their observed effectiveness, raising questions about their value. Currently, the existing knowledge base on the effectiveness and cost-effectiveness of newer oral anticancer medications in understudied populations with possible health disparities is scant. This commentary discusses what is known about palbociclib's clinical effectiveness, safety, and adherence and suggests the need for further studies of real-world effectiveness and cost-effectiveness to help establish the value of newer oncologic drugs, such as palbociclib. DISCLOSURES: No funding supported the writing of this article. The authors have nothing to disclose.
尽管在癌症的药物治疗方面已经取得了进展,但大多数患有激素受体阳性转移性乳腺癌(mBC)的绝经后妇女仍会出现疾病进展。为了寻找疗效更好、副作用更小的替代疗法,人们研发了一类新型口服抗癌药物,即细胞周期蛋白依赖性激酶(CDK)4/6 抑制剂,包括帕博西利、瑞博西利和阿贝西利。尽管如此,越来越多的证据表明,口服抗癌药物的疗效并不理想,其受低用药依从性、社会人口学因素和不良反应特征的影响。此外,CDK 4/6 抑制剂的高昂价格与其观察到的疗效之间存在脱节,这引发了对其价值的质疑。目前,关于 CDK 4/6 抑制剂在可能存在健康差异的研究较少的特定人群中的有效性和成本效益的现有知识库还很缺乏。本文讨论了帕博西利的临床疗效、安全性和用药依从性方面的已知情况,并提出需要进一步研究真实世界的疗效和成本效益,以帮助确定新型肿瘤药物(如帕博西利)的价值。披露:本文写作未获得任何资助。作者无任何利益冲突。