New Treatment Option for Metastatic Breast Cancer
~ Mona Patel, PA-C
Metastatic breast cancer is a very heterogenous disease with innumerable known and unknown biological characterictics that have an implication on disease management. These biological charcteristics translate to how the cancer behaves and grows. The patient's tumor tissue is routinely checked for these well known distinguishing factors which assist in decision making for systemic treatment. They include ER/PR receptor and Her 2 neu testing.
Most recently, the FDA approved a new treatment option for metastatic breast cancer in post-menopausal women with ER (+) and Her 2 neu (-) breast cancer. The new medication is called Palbociclib (Ibrance, which is the trade name), which is now approved to be used in conjunction with Letrozole (Femara, which is the trade name) for ER (+) and Her 2 neu (-) metastatic breast cancer.
Femara has already been used and available since 1998 as anti-estrogen therapy for ER (+) breast cancer. The addition of Palbociclib to Letrozole provides an overall response rate of 55.4% in patients receiving both drugs vs an overall response rate of 39.4% in patients receiving letrozole alone.
The most common reported side effects include abnormal blood counts, fatigue, nausea, stomatitis, decreased appetite, diarrhea, hair loss, peripheral neuropathy and increased risk of nosebleeds.
The decision of pursuing this treatment option would certainly be dependent on physician's judgment regarding tolerability of this drug combination for the patient, based on age, performance status and comorbidities. The physicians and physician extenders at Andrews and Patel Associates are now incorporating, using and educating patients about this available regimen.