Biomarkers of palbociclib response in hormone receptor-positive advanced breast cancer from the PARSIFAL trial

Abstract Currently, there are no clinically actionable biomarkers to predict patient to cyclin-dependent kinases 4 and 6 inhibitors (CDK4/6i) plus endocrine therapy for hormone receptor (HR)[+]/ human epidermal growth factor receptor 2 (HER2)[-] advanced breast cancer (ABC). Herein, we report an exp...

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Main Authors: Joan Albanell, Angelo Gámez Pozo, Carlos L. Arteaga, Meritxell Bellet, Federico Rojo, Abel González, Beatriz Bellosillo, Violeta Serra, Petra Gener, José Antonio Guerrero, Eileen Shimizu, Mario Mancino, Jose Rodríguez-Morató, Leonardo Mina, José Manuel Pérez-García, Javier Cortés, Antonio Llombart-Cussac
Format: Article
Language:English
Published: Nature Portfolio 2025-06-01
Series:npj Breast Cancer
Online Access:https://doi.org/10.1038/s41523-025-00777-0
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author Joan Albanell
Angelo Gámez Pozo
Carlos L. Arteaga
Meritxell Bellet
Federico Rojo
Abel González
Beatriz Bellosillo
Violeta Serra
Petra Gener
José Antonio Guerrero
Eileen Shimizu
Mario Mancino
Jose Rodríguez-Morató
Leonardo Mina
José Manuel Pérez-García
Javier Cortés
Antonio Llombart-Cussac
author_facet Joan Albanell
Angelo Gámez Pozo
Carlos L. Arteaga
Meritxell Bellet
Federico Rojo
Abel González
Beatriz Bellosillo
Violeta Serra
Petra Gener
José Antonio Guerrero
Eileen Shimizu
Mario Mancino
Jose Rodríguez-Morató
Leonardo Mina
José Manuel Pérez-García
Javier Cortés
Antonio Llombart-Cussac
author_sort Joan Albanell
collection DOAJ
description Abstract Currently, there are no clinically actionable biomarkers to predict patient to cyclin-dependent kinases 4 and 6 inhibitors (CDK4/6i) plus endocrine therapy for hormone receptor (HR)[+]/ human epidermal growth factor receptor 2 (HER2)[-] advanced breast cancer (ABC). Herein, we report an exploratory biomarker substudy (transFAL) from a subset of patients included in PARSIFAL, a phase II randomized clinical trial that evaluated first-line palbociclib plus fulvestrant or letrozole for HR[+]/HER2[−] ABC. No definitive biomarkers were discovered, however, worse outcomes were found with CDK6 postivity (p = 0.008), ER negativity (p = 0.008), high Ki67 (p = 0.04), and TP53 mutation (p = 0.04). ctDNA density (p = 0.036) and number of mutations (p = 0.033) at baseline were significantly higher for resistant patients. Our study reveals future directions to explore in the goal to determine biomarkers of response to CDK4/6i.
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institution Kabale University
issn 2374-4677
language English
publishDate 2025-06-01
publisher Nature Portfolio
record_format Article
series npj Breast Cancer
spelling doaj-art-0ea7b05dbd08417c804f6f914f39711f2025-08-20T03:47:17ZengNature Portfolionpj Breast Cancer2374-46772025-06-011111910.1038/s41523-025-00777-0Biomarkers of palbociclib response in hormone receptor-positive advanced breast cancer from the PARSIFAL trialJoan Albanell0Angelo Gámez Pozo1Carlos L. Arteaga2Meritxell Bellet3Federico Rojo4Abel González5Beatriz Bellosillo6Violeta Serra7Petra Gener8José Antonio Guerrero9Eileen Shimizu10Mario Mancino11Jose Rodríguez-Morató12Leonardo Mina13José Manuel Pérez-García14Javier Cortés15Antonio Llombart-Cussac16Hospital del Mar Research Institute Barcelona, Depatment of Medical Oncology, Hospital del MarTranslational Oncology Lab, University Hospital La Paz - IdiPAZUT Southwestern Simmons Comprehensive Cancer CenterVall d’Hebron Institute of OncologyHospital del Mar Research Institute Barcelona, Depatment of Medical Oncology, Hospital del MarHospital del Mar Research Institute Barcelona, Depatment of Medical Oncology, Hospital del MarHospital del Mar Research Institute Barcelona, Depatment of Medical Oncology, Hospital del MarVall d’Hebron Institute of OncologyMedica Scientia Innovation Research (MEDSIR) - Oncoclínicas&CoMedica Scientia Innovation Research (MEDSIR) - Oncoclínicas&CoMedica Scientia Innovation Research (MEDSIR) - Oncoclínicas&CoMedica Scientia Innovation Research (MEDSIR) - Oncoclínicas&CoMedica Scientia Innovation Research (MEDSIR) - Oncoclínicas&CoMedica Scientia Innovation Research (MEDSIR) - Oncoclínicas&CoMedica Scientia Innovation Research (MEDSIR) - Oncoclínicas&CoMedica Scientia Innovation Research (MEDSIR) - Oncoclínicas&CoMedica Scientia Innovation Research (MEDSIR) - Oncoclínicas&CoAbstract Currently, there are no clinically actionable biomarkers to predict patient to cyclin-dependent kinases 4 and 6 inhibitors (CDK4/6i) plus endocrine therapy for hormone receptor (HR)[+]/ human epidermal growth factor receptor 2 (HER2)[-] advanced breast cancer (ABC). Herein, we report an exploratory biomarker substudy (transFAL) from a subset of patients included in PARSIFAL, a phase II randomized clinical trial that evaluated first-line palbociclib plus fulvestrant or letrozole for HR[+]/HER2[−] ABC. No definitive biomarkers were discovered, however, worse outcomes were found with CDK6 postivity (p = 0.008), ER negativity (p = 0.008), high Ki67 (p = 0.04), and TP53 mutation (p = 0.04). ctDNA density (p = 0.036) and number of mutations (p = 0.033) at baseline were significantly higher for resistant patients. Our study reveals future directions to explore in the goal to determine biomarkers of response to CDK4/6i.https://doi.org/10.1038/s41523-025-00777-0
spellingShingle Joan Albanell
Angelo Gámez Pozo
Carlos L. Arteaga
Meritxell Bellet
Federico Rojo
Abel González
Beatriz Bellosillo
Violeta Serra
Petra Gener
José Antonio Guerrero
Eileen Shimizu
Mario Mancino
Jose Rodríguez-Morató
Leonardo Mina
José Manuel Pérez-García
Javier Cortés
Antonio Llombart-Cussac
Biomarkers of palbociclib response in hormone receptor-positive advanced breast cancer from the PARSIFAL trial
npj Breast Cancer
title Biomarkers of palbociclib response in hormone receptor-positive advanced breast cancer from the PARSIFAL trial
title_full Biomarkers of palbociclib response in hormone receptor-positive advanced breast cancer from the PARSIFAL trial
title_fullStr Biomarkers of palbociclib response in hormone receptor-positive advanced breast cancer from the PARSIFAL trial
title_full_unstemmed Biomarkers of palbociclib response in hormone receptor-positive advanced breast cancer from the PARSIFAL trial
title_short Biomarkers of palbociclib response in hormone receptor-positive advanced breast cancer from the PARSIFAL trial
title_sort biomarkers of palbociclib response in hormone receptor positive advanced breast cancer from the parsifal trial
url https://doi.org/10.1038/s41523-025-00777-0
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