engleski

Cardiac safety of palbociclib in breast cancer patients with cardiac risk

According to the results of randomised clinical studies, cardiac toxicity of palbociclib is clinically irrelevant compared to other CDK4/6 inhibitor ribociclib. Data from real world studies showed a signifi- cant difference in incidence of cardiac toxicity (atrial fibrillation, cardiac failure, myocardial infarction) between two drugs – 2.2% with palbociclib compared to 7.7% with ribociclib. We conducted retrospective analysis of data collected for four advanced breast cancer patients, median age 64 (52-78 years) with his- tory of cardiovascular diseases and significant heart risk factors (dilatative cardiomyopathy NYHA II/III, atrial fibrillation, hypertension, implantation of pacemaker), treated with combination of palbociclib and fulvestrant in first line treatment of metastatic hormon sensitive HER2 negative breast cancer. Initial car- dial status showed no clinical signs of cardial failure, average heart frequency was 60- 75/min, systolic function of left ventricle was reduced with ejection fraction (LVEF) of 45-53%, QTcF was 415-450 msec. Beside perscribed cardiac therapy patients had no comedication which could influence QTcF interval. During the treatment period (3-15 months) LVEF was stabile, no changes in the ECG record, in terms of emerging repolarisation disorders with changes in QTcF interval, and no clinically significant deteriora- tion in cardiac function were observed while all patients benefited from therapy in terms of disease con- trol. Combination therapy of palbociclib and fulvestrant showed no safety concerns in patients with sig- nificant cardiac comorbidity and increased cardiac risk.

palbociclib, cardiotoxicity, breast cancer

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