ArticleBreast cancer research and treatment2026
Antacid co-treatment and pregnane X receptor genetic polymorphisms are survival determinants in patients treated with palbociclib.
Article in Breast cancer research and treatment, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04025541 (Analysis of Circulating Tumor Markers in Blood), which is not on this map. Not yet cited in PubMed.
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Analysis of Circulating Tumor Markers in Blood
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10 authors.
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Abstract
backgroundPalbociclib is the more extensively evaluated CDK4-6 inhibitor in term of safety, efficacy and sources of pharmacokinetic variability. However, real-life data on the correlation between palbociclib plasma concentration, drug-drug interactions, gene polymorphisms and efficacy remain scarce. We previously characterized the effects of co-medications (CYP3A4 and P-glycoprotein inhibitors and antacid drugs) on palbociclib plasma concentration, and here we wanted to identify factors that influence progression-free survival in the same cohort of patients.
methodsThis multicentric prospective clinical trial included patients with metastatic breast cancer treated with first-line palbociclib and an aromatase inhibitor. Efficacy (progression-free survival) and safety (high-grade neutropenia during the first two cycles) were reported, and the influence of covariates, such as drug-drug interactions, palbociclib plasma concentration and specific gene variants, were analyzed.
resultsIn the 58 included patients, drug-drug interactions (antacid drugs) and pregnane X receptor (NR1I2) single nucleotide polymorphisms (SNP) were identified as survival prognostic factors, but not palbociclib concentration and high-grade neutropenia (p = 0.4 and p = 0.5). Concomitant antacid treatment reduced progression-free survival (26.2 vs. 32.6 months, p = 0.059) and the NR1I2 rs10934498 and rs2276707 SNPs affected survival (p = 0.002 and 0.004).
conclusionThis study consolidated the data on palbociclib as first-line metastatic breast cancer treatment and identified factors that negatively influence survival (co-treatment with antacid drugs and NR1I2 SNPs).
trial registrationNCT04025541, Registration Date 2019-07-16.
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