Effect of Concurrent Proton Pump Inhibitors With Palbociclib Tablets for Metastatic Breast Cancer

Area of Science:

• Oncology
• Pharmacology
• Clinical Trials

Background:

• Palbociclib is a key treatment for HR+/HER2- metastatic breast cancer (MBC).
• Previous studies indicated proton pump inhibitor (PPI) use reduced progression-free survival (PFS) with palbociclib capsules.
• Palbociclib tablets, approved in 2020, lack PPI use restrictions, necessitating further investigation.

Purpose of the Study:

• To evaluate the impact of concurrent proton pump inhibitor (PPI) use on PFS in patients receiving palbociclib tablets for HR+/HER2- MBC.
• To compare PFS, overall survival (OS), and adverse events between patients using PPIs and those not using PPIs concurrently with palbociclib tablets.

Main Methods:

• Retrospective evaluation of 82 patients with HR+/HER2- MBC treated with palbociclib tablets.
• Patients were categorized into 'no PPI use' or 'PPI use' (>50% of therapy duration).
• Primary endpoint was progression-free survival (PFS); secondary endpoints included overall survival (OS) and adverse events.

Main Results:

• No significant difference in median PFS was observed between the no PPI use arm (20.6 months) and the PPI use arm (21.0 months) (P = 0.95).
• Median overall survival (OS) was not reached in either group.
• Adverse events were comparable between the two arms.

Conclusions:

• Concurrent use of proton pump inhibitors (PPIs) with palbociclib tablets does not significantly reduce progression-free survival (PFS) in HR+/HER2- metastatic breast cancer (MBC) patients.
• The findings suggest that PPIs can be safely used with palbociclib tablets, unlike previous concerns with palbociclib capsules.
• Further research may explore the mechanisms behind this difference and confirm long-term outcomes.