Pfizer Inc, Groton, Connecticut, USA.
Pfizer Inc, San Diego, California, USA.
Clin Pharmacol Ther. 2022 Jan;111(1):302-309. doi: 10.1002/cpt.2454. Epub 2021 Nov 19.
This report examined the benefits and risks of palbociclib plus endocrine therapy (ET) in men with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (MBC). Palbociclib was evaluated using three independent data sources: real-world data from pharmacy and medical claims, a de-identified real-world data source derived from electronic health records (EHRs), and a global safety database. From medical and pharmacy records, 1,139 men with MBC were identified; in the first-line setting, median duration of treatment was longer with palbociclib plus ET (n = 37, 8.5 months, 95% confidence interval (CI), 4.4-13.0) than ET alone (n = 214, 4.3 months, 95% CI, 3.0-5.7) and specifically, was longer with palbociclib plus letrozole (n = 26, 9.4 months, 95% CI, 4.4-14.0) than letrozole alone (n = 63, 3.0 months, 95% CI, 1.8-4.8). In the EHR-derived database, 59 men received treatment for MBC; real-world response across all lines of therapy in the metastatic setting was reported in 4 of 12 patients (33.3%) in the palbociclib plus ET group vs. 1 of 8 (12.5%) patients in the ET group. Review of the global safety database did not identify any new safety signals in palbociclib-treated men. Real-world data indicated that men with MBC benefit from palbociclib plus ET, with a safety profile consistent with previous observations in women with MBC. Collective data on palbociclib in women and men in this report, including clinical trial data, real-world data, and a well-established risk/benefit profile, led to US approval of an expansion of the palbociclib indication to include men with MBC.
本报告探讨了帕博西尼联合内分泌治疗(ET)在激素受体阳性(HR+)/人表皮生长因子受体 2 阴性(HER2-)转移性乳腺癌(MBC)男性患者中的获益和风险。帕博西尼使用三个独立的数据来源进行评估:来自药房和医疗索赔的真实世界数据、来自电子健康记录(EHR)的去标识真实世界数据来源,以及全球安全性数据库。从医疗和药房记录中,确定了 1139 名 MBC 男性患者;在一线治疗环境中,与 ET 单药治疗相比(n=214,4.3 个月,95%置信区间[CI],3.0-5.7),帕博西尼联合 ET(n=37)治疗的中位持续时间更长(8.5 个月,95%CI,4.4-13.0),特别是与 palbociclib 联合 letrozole(n=26)相比,letrozole 单药治疗(n=63)的中位持续时间更长(9.4 个月,95%CI,4.4-14.0)。在 EHR 衍生数据库中,59 名男性接受了 MBC 治疗;在转移性环境下,所有治疗线的真实世界反应在帕博西尼联合 ET 组的 12 名患者中有 4 名(33.3%),而 ET 组的 8 名患者中有 1 名(12.5%)。对全球安全性数据库的审查未发现帕博西尼治疗男性患者的任何新的安全性信号。真实世界数据表明,MBC 男性患者从 palbociclib 联合 ET 中获益,安全性与 MBC 女性患者先前观察到的一致。本报告中关于 palbociclib 在女性和男性中的集体数据,包括临床试验数据、真实世界数据和成熟的风险/获益概况,导致美国批准扩大 palbociclib 的适应症,纳入 MBC 男性患者。