Palbociclib

(Ibrance®)

Palbociclib

Drug updated on 5/2/2024

Dosage FormCapsule (oral; 75 mg, 100 mg, 125 mg); Tablet (oral; 75 mg, 100 mg, 125 mg)
Drug ClassKinase inhibitors
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the treatment of adult patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer in combination with: an aromatase inhibitor as initial endocrine-based therapy in postmenopausal women or in men.
  • Indicated for the treatment of adult patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer in combination with: Fulvestrant in patients with disease progression following endocrine therapy.

Summary
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  • Palbociclib (Ibrance) is indicated for the treatment of adult patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced or metastatic breast cancer.
  • A total of 25 systematic reviews and meta-analyses were reviewed to gather information about this drug's effectiveness and safety profile.
  • When combined with endocrine therapy, palbociclib significantly improves progression-free survival and overall survival in patients compared to those receiving endocrine therapy alone.
  • Compared to other cyclin-dependent kinase 4/6 inhibitors such as ribociclib and abemaciclib, palbociclib shows similar effectiveness in improving patient outcomes but may have minor differences based on indirect comparisons using SUCRA values.
  • Specific population subgroups like postmenopausal women or those who have progressed after prior endocrine therapy also benefit from combinations involving palbociclib; its efficacy remains consistent across various demographics and disease severities.
  • Neutropenia is a significant concern associated with CDK4/6 inhibitors including palbociclib; however, rates of severe neutropenia vary among these drugs - while often cited for notable incidence with Ibrance use it isn't necessarily higher than that seen with ribocilib usage whereas abemaciclic has lower rates but higher instances of diarrhea side effects.
  • Adverse events reported for Ibrance generally include hematologic toxicities (notably neutropenia), fatigue, nausea, alopecia etc., yet discontinuation due to adverse events are lower when compared against chemotherapy agents & comparable/favorable when pitted against other CDK4/6is.
  • Economic evaluations indicate that despite their clinical benefits the high costs associated with CDK4/6is including Ibrance pose challenges towards widespread accessibility & utility – comparatively speaking Ribcilib plus Letrozole might offer slightly better economic benefits over Ibrance plus Letrozole in specific settings.

Product Monograph / Prescribing Information

Document TitleYearSource
Ibrance (palbociclib-capsules) Prescribing Information.2023Pfizer labs., NY, NY
Ibrance (palbociclib-tablets) Prescribing Information.2023Pfizer labs., NY, NY

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Palbociclib in older patients with advanced/metastatic breast cancer: a systematic review.2024Targeted Oncology
Comparative overall survival of CDK4/6 inhibitors in combination with endocrine therapy in advanced breast cancer.2024Scientific Reports
The likelihood of being helped or harmed as a patient-centred tool to assess cyclin dependent kinase 4/6 inhibitors clinical impact and safety in metastatic breast cancer: a systematic review and sensitivity-analysis.2023EClinicalMedicine
An overview of the safety profile and clinical impact of cdk4/6 inhibitors in breast cancer-a systematic review of randomized phase ii and iii clinical trials.2023Biomolecules
Safety profile of cyclin-dependent kinase (CDK) 4/6 inhibitors with concurrent radiation therapy: a systematic review and meta-analysis.2023Cancer Treatment Reviews
Second-line endocrine therapy of hormone receptor-positive/HER2-negative advanced breast cancer: a systematic review and network meta-analysis.2023Current Cancer Drug Targets
Health-related quality of life in breast cancer patients treated with CDK4/6 inhibitors: a systematic review.2022ESMO Open
Progression-free survival and overall survival of CDK 4/6 inhibitors plus endocrine therapy in metastatic breast cancer: a systematic review and meta-analysis.2022International Journal of Molecular Sciences
Neoadjuvant therapy of cyclin-dependent kinase 4/6 inhibitors combined with endocrine therapy in HR+/HER2- breast cancer: a systematic review and meta-analysis.2021Oncology Research and Treatment
CDK4/6 inhibitors in HR+/HER2- advanced/metastatic breast cancer: a systematic literature review of real-world evidence studies.2021Future Oncology
Oral adverse effects of CDK4/6 inhibitors among breast cancer patients: a systematic review and meta-analysis.2021Annals of Palliative Medicine
Emerging skin toxicities in patients with breast cancer treated with new cyclin dependent kinase 4/6 inhibitors: a systematic review.2021Drug Safety
Efficacy and safety of CDK4/6 and PI3K/AKT/mTOR inhibitors as second-line treatment in postmenopausal patients with hormone receptor-positive, HER-2-negative metastatic breast cancer: a network meta-analysis.2021Expert Opinion on Drug Safety
Comparison of endocrine therapies in hormone receptor-positive and human epidermal growth factor receptor 2-negative locally advanced or metastatic breast cancer: a network meta-analysis.2020Journal of Breast Cancer
Comparison of treatment-related adverse events of different cyclin dependent kinase 4/6 inhibitors in metastatic breast cancer: a network meta-analysis.2020Cancer Treatment Reviews
CDK4/6 inhibitors in breast cancer: differences in toxicity profiles and impact on agent choice. a systematic review and meta-analysis.2020Expert Review of Anticancer Therapy
Endocrine therapies in postmenopausal women with hormone receptor-positive, human epidermal growth factor receptor 2-negative, pretreated, advanced breast cancer: a network meta-analysis.2020Medicine
Cyclin‑dependent kinase 4/6 inhibitors in combination with fulvestrant for previously treated metastatic hormone receptor‑positive breast cancer patients: a systematic review and meta‑analysis of randomized clinical trials.2020Cancer Treatment and Research
Venous thromboembolism risk in patients with hormone receptor-positive HER2-negative metastatic breast cancer treated with combined CDK 4/6 inhibitors plus endocrine therapy versus endocrine therapy alone: a systematic review and meta-analysis of randomized controlled trials.2020Breast Cancer Research and Treatment
Endocrine treatment versus chemotherapy in postmenopausal women with hormone receptor-positive, HER2-negative, metastatic breast cancer: a systematic review and network meta-analysis.2019The Lancet Oncology
Systematic literature review of clinical trials of endocrine therapies for premenopausal women with metastatic HR+ HER2- breast cancer.2019The Breast Journal
Treatment of advanced HR+/HER2- breast cancer with new targeted agents in combination with endocrine therapy: a review of efficacy and tolerability based on available randomized trials on everolimus, ribociclib, palbociclib and abemaciclib.2019Acta Oncologica
Comparative efficacy of CDK4/6 inhibitors plus aromatase inhibitors versus fulvestrant for the first-line treatment of hormone receptor-positive advanced breast cancer: a network meta-analysis.2019Targeted Oncology

Clinical Practice Guidelines