Real-World Safety Profile of Generic Palbociclib in Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer: A Prospective Observational Study in Iraq”
- Authors
-
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Rawaa Abdulzahra Mohammed Hussein
Oncology Teaching Hospital, Medical City Complex, Baghdad, Iraq -
Abeer Abdulhadi Rashid
Mustansiriyah University, College of Pharmacy, Baghdad, Iraq -
Zahraa Matheel Nasir
Oncology Teaching Hospital, Medical City Complex, Baghdad, Iraq
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- Keywords:
- Generic Palbociclib, Metastatic breast cancer, safety profile
- Abstract
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Background: Breast cancer accounts for the highest incidence of cancer among Iraqi women. Generic Palbociclib has recently become available, yet there remains a lack of real-world clinical equivalence data.
Methods: A prospective observational study carried out between September 2024 & April 2025 at the oncology teaching hospital in the medical city complex with (175) participants included those on generic palbciclib with fluvestrant or Aromatase inhibitor(AI). All participants were completed the study without any dropouts.
Results: Neutropenia was common in both AI (88.3%) and Fluvestrant (87.2%) groups. Increase in Anemia was more marked in the Fulvestrant group (93.6%) than in AI (63.3%) with p-value <0.001), and the same for hair loss p=0.005; 46.8% and urticaria (p =0.019 , 19.1%). The mean age in each of the groups was similar (50.8 years vs 51.6 years), indicating that age did not have a significant effect on association found. As all patients had ECOG performance status of 0 to 1, performance status was not considered in the regression analysis because of lack of variability.
Conclusion: Generic Palbociclib safety profile is consistent with initial studies and historical data and it’s tolerability is confirmed under-resourced settings.
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[1] Zahwe M, Bendahhou K, Eser S, Mukherji D, Fouad H, Fadhil I, Soerjomataram I, Znaor A. Current and future burden of female breast cancer in the Middle East and North Africa region using estimates from GLOBOCAN 2022. Int J Cancer 2025; 156(12): 2320-9.
[2] Alwan NSA. Breast Cancer Among Iraqi Women: Preliminary Findings From a Regional Comparative Breast Cancer Research Project. J Glob Oncol 2016; 2(5): 255-8.
[3] Najah MZ, et al. Breast cancer incidence trends in Iraq from 2000 to 2009: population-based registry data. Asian Pac J Cancer Prev 2014; 15(1): 281-6.
[4] Spring LM, Wander SA, Andre F, Moy B, Turner NC, Bardia A. Cyclin-dependent kinase 4 and 6 inhibitors for hormone receptor-positive breast cancer: past, present, and future. Lancet 2020; 395(10226): 817-27.
[5] Rauthan A, Jain A, Singh M, Sendur MAN. Palbociclib in HR-positive, HER2-negative advanced/metastatic breast cancer: A systematic scoping review of real-world evidence from countries outside Western regions. Oncol Ther 2024; 12(3): 395-418.
[6] Oprean CM, Badau LM, Petrita R, Median MD, Dema A. Real-world, national study of palbociclib in HR+/HER2- metastatic breast cancer: 2.5-year follow-up PALBO01/2021. Diagnostics 2025; 15(9): 1173.
[7] Sibaud V, Sollena P. Dermatologic toxicities to inhibitors of cyclin-dependent kinases CDK4 and 6: An updated review for clinical practice. Ann Dermatol Venereol 2023; 150(3): 208-12.
[8] Silvestri M, Cristaudo A, Morrone A, et al. Emerging skin toxicities in patients with breast cancer treated with new CDK4/6 inhibitors: A systematic review. Drug Saf 2021; 44(7): 725-32.
[9] De Giorgi V, et al. Cyclin-dependent kinase 4/6 inhibitors and dermatologic adverse events: Results from the EADV Task Force “Dermatology for Cancer Patients.” Cancers 2023; 15(14): 3658.
[10] Raschi E, et al. Comparative analysis of adverse events associated with CDK4/6 inhibitors using FDA pharmacovigilance. BMC Pharmacol Toxicol 2024; 25: [pages unknown].
[11] DeMichele A, Clark AS, Tan KS, Heitjan DF, Gomella LG, Gallagher M, et al. CDK4/6 inhibitor use in clinical practice: real-world outcomes. J Clin Oncol 2021; 39(15_suppl): e12522.
[12] Finn RS, Martin M, Rugo HS, Jones S, Im SA, Gelmon K, et al. Palbociclib and letrozole in advanced breast cancer (PALOMA-2). N Engl J Med 2016; 375(20): 1925-36.
[13] Cristofanilli M, Rugo HS, Im SA, Slamon DJ, Harbeck N, Bondarenko I, et al. Overall survival with palbociclib and fulvestrant in women with HR+/HER2− advanced breast cancer (PALOMA-3). Clin Cancer Res 2022; 28(16): 3433-42.
[14] Verma S, Bartlett CH, Schnell P, DeMichele AM, Loi S, Ro J, et al. Palbociclib plus fulvestrant safety analysis (PALOMA-3). Oncologist 2016; 21(10): 1165-75.
[15] Spring LM, Wander SA, Andre F, Moy B, Turner NC, Bardia A. CDK4/6 inhibitors in breast cancer. Lancet 2020; 395(10226): 817-27.
[16] Finn RS, Dering J, Conklin D, Kalous O, Cohen DJ, Desai AJ, et al. PD 0332991 (palbociclib) selectively inhibits CDK4/6 and induces G1 arrest. Breast Cancer Res 2009; 11(5): R77.
[17] Goel S, DeCristo MJ, Watt AC, BrinJones H, Sceneay J, Li BB, et al. CDK4/6 inhibition triggers anti-tumor immunity. Nature 2017; 548(7668): 471-5.
[18] Deng J, Wang ES, Jenkins RW, Li S, Dries R, Yates K, et al. CDK4/6 inhibition augments antitumor immunity. Cancer Discov 2018; 8(2): 216-33.
[19] Burstein HJ, Somerfield MR, Barton DL, Dorris A, Fallowfield LJ, Jain D, et al. Endocrine therapy for HR+ metastatic breast cancer: ASCO guideline. J Clin Oncol 2021; 39(35): 3959-77.
[20] Sledge GW Jr, Toi M, Neven P, Sohn J, Inoue K, Pivot X, et al. MONARCH 2: abemaciclib plus fulvestrant. J Clin Oncol 2017; 35(25): 2875-84.
[21] Tripathy D, Im SA, Colleoni M, Franke F, Bardia A, Harbeck N, et al. Ribociclib plus endocrine therapy (MONALEESA-7). Lancet Oncol 2018; 19(7): 904-15.
[22] Rugo HS, Rumble RB, Macrae E, Barton DL, Connolly HK, Dickler MN, et al. Endocrine therapy for HR+ MBC: ASCO guideline update. J Clin Oncol 2021; 39(35): 3959-77.
[23] Alkema L, Chou D, Hogan D, Zhang S, Moller AB, Gemmill A, et al. Global burden and health system challenges in low-resource settings. Lancet Glob Health 2016; 4(12): e901-11.
[24] Cardoso F, Paluch-Shimon S, Senkus E, Curigliano G, Aapro MS, Andre F, et al. 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5). Ann Oncol 2020; 31(12): 1623-49.
[25] Sherr CJ, Roberts JM. CDK inhibitors: positive and negative regulators of G1-phase progression. Genes Dev 1999; 13(12): 1501-12.
[26] Bui TBV, Burgers DM, Agterof MJ, van den Bent MJ. Dermatologic adverse events of CDK4/6 inhibitors. Breast Cancer Res Treat 2021; 186(2): 301-8.
[27] Raschi E, Poluzzi E, Salvo F, Pariente A, Biselli M, De Ponti F. Pharmacovigilance of CDK4/6 inhibitors: dermatologic toxicity. Drug Saf 2021; 44(2): 199-212.
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- 09-06-2026
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