Palbosiklib–letrozol ve ribosiklib–letrozol kombinasyonlarının metastatik HR+ / HER2- meme kanserinde birinci basamak tedavide etkinlik ve güvenlilik açısından karşılaştırılması

Salih Tünbekici; Pınar Gürsoy; Erdem Göker

doi:10.19161/etd.1681813

EN TR

Comparison of palbociclib–letrozole and ribociclib–letrozole combinations as first-line treatment in metastatic HR+ / HER2- breast cancer

Abstract

Aim: The aim of this study was to compare the efficacy and safety of palbociclib–letrozole and ribociclib–letrozole combinations as first-line treatment in patients with hormone receptor (HR) positive and human epidermal growth factor receptor 2 (HER2) negative metastatic breast cancer. Materials and Methods: This retrospective study included 98 patients with HR positive and HER2 negative metastatic breast cancer who received palbociclib or ribociclib in combination with letrozole at Ege University Faculty of Medicine between January 1, 2018, and December 31, 2024. The median follow-up duration was 37,5 months. Progression-free survival, overall survival, objective response rate, and treatment-related toxicities were evaluated. Results: The median progression-free survival in the entire cohort was 25,0 months. In the palbociclib group, the median progression-free survival was 25,0 months, while it was 27,0 months in the ribociclib group; the difference between the groups was not statistically significant (p = 0,064). The estimated 5-year overall survival rates were 50% in the palbociclib group and 52% in the ribociclib group, with no significant difference observed between the groups (p = 0,764). The objective response rate in the overall cohort was 70,4%, with no statistically significant difference between treatment arms. The most commonly reported toxicity in both groups was neutropenia, which was observed at a higher rate in the palbociclib group. In contrast, non-hematologic adverse events, particularly hepatotoxicity and rash, were more frequently observed in the ribociclib group. Conclusion: Palbociclib and ribociclib combinations demonstrate similar efficacy and safety profiles as first-line treatments in patients with HR positive / HER2 negative metastatic breast cancer. Based on our real-world data, both regimens appear to be well tolerated. A personalized treatment approach, taking into account both efficacy and toxicity profiles, is recommended to guide clinical decision-making.

Keywords

Palbosiklib–letrozol ve ribosiklib–letrozol kombinasyonlarının metastatik HR+ / HER2- meme kanserinde birinci basamak tedavide etkinlik ve güvenlilik açısından karşılaştırılması

Öz

Amaç: Bu çalışmanın amacı, hormon reseptörü (HR) pozitif ve insan epidermal büyüme faktörü reseptörü 2 (HER2) negatif metastatik meme kanserli hastalarda, birinci basamak tedavi olarak kullanılan palbosiklib–letrozol ve ribosiklib–letrozol kombinasyonlarını etkinlik ve güvenlilik açısından karşılaştırmaktır. Gereç ve Yöntem: Bu çalışma retrospektif olarak tasarlanmıştır. Çalışmaya, 1 Ocak 2018 ile 31 Aralık 2024 tarihleri arasında Ege Üniversitesi Tıp Fakültesi’nde HR pozitif / HER2 negatif metastatik meme kanseri tanısıyla palbosiklib veya ribosiklib ile birlikte letrozol tedavisi almış 98 hasta dahil edilmiştir. Medyan takip süresi 37,5 ay olup; progresyonsuz sağkalım, genel sağkalım, objektif yanıt oranı ve tedaviye bağlı toksisiteler değerlendirilmiştir. Bulgular: Tüm kohortta medyan progresyonsuz sağkalım 25,0 ay olarak hesaplanmıştır. Palbosiklib grubunda medyan progresyonsuz sağkalım 25,0 ay, ribosiklib grubunda ise 27,0 ay olarak bulunmuştur; iki grup arasındaki fark istatistiksel olarak anlamlı değildir (p = 0,064). Beş yıllık tahmini genel sağkalım oranları palbosiklib ve ribosiklib gruplarında sırasıyla %50 ve %52 olarak hesaplanmıştır; gruplar arasında anlamlı fark izlenmemiştir (p = 0,764). Tüm kohortta objektif yanıt oranı %70,4 olarak bulunmuştur ve tedavi kolları arasında anlamlı fark saptanmamıştır. Her iki gurupta da en sık bildirilen toksisite nötropeni olup, palbosiklib grubunda daha yüksek oranda gözlenmiştir. Ribosiklib grubunda ise non-hematolojik yan etkiler, özellikle hepatotoksisite ve döküntü, daha sık izlenmiştir. Sonuç: Palbosiklib ve ribosiklib kombinasyonları, HR pozitif / HER2 negatif metastatik meme kanserinde birinci basamak tedavide benzer etkinlik ve güvenlilik profili sergilemektedir. Gerçek yaşam verilerimize göre her iki tedavi de genel olarak iyi tolere edilmekte olup, klinik kararlarda etkinlik ve yan etki profili dikkate alınarak bireyselleştirilmiş bir tedavi yaklaşımının benimsenmesi önerilmektedir.

Anahtar Kelimeler

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Details

Primary Language

Turkish

Subjects

Clinical Oncology

Journal Section

Research Article

Authors

Salih Tünbekici ^*
0000-0001-8804-7636
Türkiye

Pınar Gürsoy
0000-0003-1392-6753
Türkiye

Erdem Göker
0000-0001-6180-713X
Türkiye

Publication Date

September 8, 2025

Submission Date

April 22, 2025

Acceptance Date

May 13, 2025

Published in Issue

Year 2025 Volume: 64 Number: 3

DOI

https://doi.org/10.19161/etd.1681813

IZ

https://izlik.org/JA88SR67UB

Cite

RIS / Bibtex

Vancouver

1.Salih Tünbekici, Pınar Gürsoy, Erdem Göker. Palbosiklib–letrozol ve ribosiklib–letrozol kombinasyonlarının metastatik HR+ / HER2- meme kanserinde birinci basamak tedavide etkinlik ve güvenlilik açısından karşılaştırılması. EJM. 2025 Sep. 1;64(3):510-8. doi:10.19161/etd.1681813