Impact of age and comorbidities on real-world outcomes in advanced breast cancer patients treated with palbociclib in first line: a nation-wide Danish retrospective study

Background and purpose: Palbociclib, a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor, combined with aromatase inhibitors (AI), can be used in first-line treatment for estrogen receptor (ER) positive, human epidermal growth factor receptor 2 (HER2) normal advanced breast cancer (ABC). This study aim...

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Main Authors: Alan Celik, Laurits Sebastian Dahl, Rasmus Garly, Vesna Glavicic, Maja Bendtsen Sharma, Sophie Yammeni, Humma Khan, Daniel Sloth Hauberg, Hanne Schultz Kapel, Ann Knoop, Tobias Berg
Format: Article
Language:English
Published: Medical Journals Sweden 2025-06-01
Series:Acta Oncologica
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Online Access:https://medicaljournalssweden.se/actaoncologica/article/view/43226
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author Alan Celik
Laurits Sebastian Dahl
Rasmus Garly
Vesna Glavicic
Maja Bendtsen Sharma
Sophie Yammeni
Humma Khan
Daniel Sloth Hauberg
Hanne Schultz Kapel
Ann Knoop
Tobias Berg
author_facet Alan Celik
Laurits Sebastian Dahl
Rasmus Garly
Vesna Glavicic
Maja Bendtsen Sharma
Sophie Yammeni
Humma Khan
Daniel Sloth Hauberg
Hanne Schultz Kapel
Ann Knoop
Tobias Berg
author_sort Alan Celik
collection DOAJ
description Background and purpose: Palbociclib, a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor, combined with aromatase inhibitors (AI), can be used in first-line treatment for estrogen receptor (ER) positive, human epidermal growth factor receptor 2 (HER2) normal advanced breast cancer (ABC). This study aims to assess the impact of age and comorbidities on the progression-free survival (PFS) and overall survival (OS) of patients treated with palbociclib and AI. Materials and methods: This nationwide, retrospective cohort study included 604 women with ER positive, HER2 normal ABC treated with palbociclib and an AI between 2017 and 2021. Data were obtained from the Danish Breast Cancer Group database. Survival outcomes were analyzed based on age, Charlson Comorbidity Index (CCI), number of comorbidities, and comorbidity type. PFS and OS were estimated using the Kaplan–Meier method. Results: Median PFS for all patients was 30.6 months (95% confidence interval [CI], 27.4–34.2), and median OS was 55.6 months (95% CI, 51.8–58.9). Patients aged 65–75 years had significantly longer PFS and OS (p = 0.031 and p = 0.012) than patients aged under 65 and over 75 years. Visceral metastases were associated with shorter PFS and OS (p = 0.005). Comorbidity burden, including CCI score and comorbidity type, did not significantly affect survival outcomes. Interpretation: In our data set, univariate analyses suggest age and visceral metastases to be potential factors influencing outcomes in patients with ABC treated with palbociclib plus an AI. Comorbidities, did not significantly impact survival, suggesting that palbociclib is well-tolerated in patients with varying health profiles. ClinicalTrials.gov ID: NCT06307457.
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series Acta Oncologica
spelling doaj-art-90a7d6851e4b4a218ce24dc5eeff84292025-08-20T03:25:15ZengMedical Journals SwedenActa Oncologica1651-226X2025-06-016410.2340/1651-226X.2025.43226Impact of age and comorbidities on real-world outcomes in advanced breast cancer patients treated with palbociclib in first line: a nation-wide Danish retrospective studyAlan Celik0https://orcid.org/0000-0001-9952-6472Laurits Sebastian Dahl1Rasmus Garly2Vesna Glavicic3Maja Bendtsen Sharma4Sophie Yammeni5Humma Khan6Daniel Sloth Hauberg7Hanne Schultz Kapel8Ann Knoop9https://orcid.org/0000-0003-2898-1093Tobias Berg10https://orcid.org/0000-0003-2006-6616Danish Breast Cancer Group, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Zealand University Hospital, Emergency Department, Nykoebing F, DenmarkDanish Breast Cancer Group, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DenmarkDanish Breast Cancer Group, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DenmarkDepartment of Oncology, Zealand University Hospital, Naestved, DenmarkDepartment of Oncology, Aarhus University Hospital, Aarhus, DenmarkDepartment of Oncology, Aalborg University Hospital, Aalborg, DenmarkPfizer ApS, Ballerup, DenmarkPfizer ApS, Ballerup, DenmarkPfizer ApS, Ballerup, DenmarkDepartment of Clinical Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DenmarkDanish Breast Cancer Group, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DenmarkBackground and purpose: Palbociclib, a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor, combined with aromatase inhibitors (AI), can be used in first-line treatment for estrogen receptor (ER) positive, human epidermal growth factor receptor 2 (HER2) normal advanced breast cancer (ABC). This study aims to assess the impact of age and comorbidities on the progression-free survival (PFS) and overall survival (OS) of patients treated with palbociclib and AI. Materials and methods: This nationwide, retrospective cohort study included 604 women with ER positive, HER2 normal ABC treated with palbociclib and an AI between 2017 and 2021. Data were obtained from the Danish Breast Cancer Group database. Survival outcomes were analyzed based on age, Charlson Comorbidity Index (CCI), number of comorbidities, and comorbidity type. PFS and OS were estimated using the Kaplan–Meier method. Results: Median PFS for all patients was 30.6 months (95% confidence interval [CI], 27.4–34.2), and median OS was 55.6 months (95% CI, 51.8–58.9). Patients aged 65–75 years had significantly longer PFS and OS (p = 0.031 and p = 0.012) than patients aged under 65 and over 75 years. Visceral metastases were associated with shorter PFS and OS (p = 0.005). Comorbidity burden, including CCI score and comorbidity type, did not significantly affect survival outcomes. Interpretation: In our data set, univariate analyses suggest age and visceral metastases to be potential factors influencing outcomes in patients with ABC treated with palbociclib plus an AI. Comorbidities, did not significantly impact survival, suggesting that palbociclib is well-tolerated in patients with varying health profiles. ClinicalTrials.gov ID: NCT06307457. https://medicaljournalssweden.se/actaoncologica/article/view/43226Advanced Breast CancerPalbociclibCDK4/6 inhibitorsurvivalagecomorbidity
spellingShingle Alan Celik
Laurits Sebastian Dahl
Rasmus Garly
Vesna Glavicic
Maja Bendtsen Sharma
Sophie Yammeni
Humma Khan
Daniel Sloth Hauberg
Hanne Schultz Kapel
Ann Knoop
Tobias Berg
Impact of age and comorbidities on real-world outcomes in advanced breast cancer patients treated with palbociclib in first line: a nation-wide Danish retrospective study
Acta Oncologica
Advanced Breast Cancer
Palbociclib
CDK4/6 inhibitor
survival
age
comorbidity
title Impact of age and comorbidities on real-world outcomes in advanced breast cancer patients treated with palbociclib in first line: a nation-wide Danish retrospective study
title_full Impact of age and comorbidities on real-world outcomes in advanced breast cancer patients treated with palbociclib in first line: a nation-wide Danish retrospective study
title_fullStr Impact of age and comorbidities on real-world outcomes in advanced breast cancer patients treated with palbociclib in first line: a nation-wide Danish retrospective study
title_full_unstemmed Impact of age and comorbidities on real-world outcomes in advanced breast cancer patients treated with palbociclib in first line: a nation-wide Danish retrospective study
title_short Impact of age and comorbidities on real-world outcomes in advanced breast cancer patients treated with palbociclib in first line: a nation-wide Danish retrospective study
title_sort impact of age and comorbidities on real world outcomes in advanced breast cancer patients treated with palbociclib in first line a nation wide danish retrospective study
topic Advanced Breast Cancer
Palbociclib
CDK4/6 inhibitor
survival
age
comorbidity
url https://medicaljournalssweden.se/actaoncologica/article/view/43226
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