Evidence map›Paper›PMID 40294349›Full record

Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2025

Second-Line Endocrine Therapy With or Without Palbociclib Rechallenge in Patients With Hormone Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer: PALMIRA Trial.

Antonio Llombart-Cussac, Catherine Harper-Wynne, Antonia Perelló, Audrey Hennequin, Adela Fernández-Ortega, Marco Colleoni, Sara Marín, Vanesa Quiroga, Jacques Medioni, Vega Iranzo and 11 more

Abstract readClinical Trial, Phase IIRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
49citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

49 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Trial
  5. Imlunestrant with or without abemaciclib in advanced breast cancer: updated efficacy results from the phase III EMBER-3 trial.Annals of oncology : official journal of the European Society for Medical Oncology · 2026
    Trial
  6. Abemaciclib Plus Fulvestrant in Advanced Breast Cancer After Progression on CDK4/6 Inhibition: Results From the Phase III postMONARCH Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025
    Trial
  7. Trial
  8. Review
  9. Article
  10. Article
  11. Observational
  12. Article
  13. Article
  14. Review
  15. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Antonio Llombart-CussacMedica Scientia Innovation Research (MEDSIR), Barcelona, Spain.ORCID 0000-0003-4515-8293
Catherine Harper-WynneMaidstone Hospital - Kent Oncology Centre, Maidstone, United Kingdom.ORCID 0000-0002-8414-6722
Antonia PerellóHospital Universitari Son Espases, Palma de Mallorca, Spain.
Audrey HennequinCentre Georges François Leclerc, Dijon, France.
Adela Fernández-OrtegaInstitut Català d'Oncologia L'Hospitalet (ICO), Barcelona, Spain.ORCID 0000-0001-5921-0246
Marco ColleoniIEO, Instituto Europeo di Oncologia, IRCCS, Milan, Italy.ORCID 0000-0002-5743-3013
Sara MarínHospital Arnau de Vilanova, FISABIO, Valencia, Spain.ORCID 0009-0009-9756-0939
Vanesa QuirogaInstitut Català d'Oncologia Badalona (ICO), Barcelona, Spain.
Jacques MedioniHôpital Européen Georges Pompidou, Paris, France.
Vega IranzoConsorci Hospital General Universitari de València, Valencia, Spain.ORCID 0000-0001-6183-5173
Duncan WheatleyRoyal Cornwall Hospital NHS Trust, Cornwall, United Kingdom.
Sonia Del Barco BerrónInstitut Català d'Oncologia Girona (ICO), Girona, Spain.ORCID 0000-0002-4951-6871
Antonio AntónHospital Universitario Miguel Servet, Zaragoza, Spain.ORCID 0000-0002-1925-4102
Erion DobiHôpital Jean Minjoz, Doubs, France.
Manuel Ruiz-BorregoHospital Universitario Virgen del Rocío, Sevilla, Spain.ORCID 0000-0002-1181-5622
Daniel Alcalá-LópezMedica Scientia Innovation Research (MEDSIR), Barcelona, Spain.ORCID 0000-0003-2184-1346
Jhudit Pérez-EscuredoMedica Scientia Innovation Research (MEDSIR), Barcelona, Spain.ORCID 0009-0009-1691-1849
Gabriele AntonarelliDivision of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy.ORCID 0000-0002-9758-3665
Miguel Sampayo-CorderoMedica Scientia Innovation Research (MEDSIR), Barcelona, Spain.ORCID 0000-0003-1469-3410
José Manuel Pérez-GarcíaMedica Scientia Innovation Research (MEDSIR), Barcelona, Spain.ORCID 0009-0004-2204-2014
Javier CortésMedica Scientia Innovation Research (MEDSIR), Barcelona, Spain.ORCID 0000-0001-7623-1583

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors plus endocrine therapy (ET) represents the standard first-line treatment for patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HER2-negative) advanced breast cancer (ABC). However, there is no definitive consensus on the preferred second-line treatment option. The PALMIRA trial investigated whether palbociclib rechallenge with an alternative ET would improve the antitumor activity in patients progressing after a first-line palbociclib-containing regimen.

methodsThis international, randomized, open-label, phase II study enrolled 198 patients with hormone receptor-positive/HER2-negative ABC with disease progression after first-line palbociclib plus ET (aromatase inhibitor or fulvestrant). Patients were eligible if they showed clinical benefit to the previous regimen (response or stable disease ≥24 weeks) or had progressed on a palbociclib-based therapy in the adjuvant setting. Patients were randomly assigned (2:1 ratio) to either palbociclib rechallenge plus second-line ET (fulvestrant or letrozole) or second-line ET alone. Stratification factors were previous ET and visceral involvement. The primary end point was investigator-assessed progression-free survival (PFS).

resultsBetween April 2019 and October 2022, 136 and 62 patients were randomly assigned to palbociclib plus ET or ET alone, respectively. Median investigator-assessed PFS was 4.9 months (95% CI, 3.6 to 6.1) with palbociclib plus ET versus 3.6 months (95% CI, 2.5 to 4.2) with ET alone (hazard ratio, 0.84 [95% CI, 0.66 to 1.07];

conclusionPalbociclib rechallenge plus an alternative ET did not significantly improve PFS compared with ET alone in patients with hormone receptor-positive/HER2-negative ABC progressing on a first-line palbociclib-based ET regimen.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsPiperazinesPyridinesAdultAgedAged, 80 and overAromatase InhibitorsErb-b2 Receptor Tyrosine KinasesFemaleFulvestrantHumansLetrozoleMiddle AgedReceptors, EstrogenReceptors, ProgesteroneAromatase InhibitorsERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesFulvestrantLetrozolepalbociclibPiperazinesPyridinesReceptors, EstrogenReceptors, Progesterone

Identifiers

PMID40294349
PMCPMC12169856

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.