Difference between revisions of "Palbociclib (Ibrance)"

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==General information==
 
==General information==
Class/mechanism:  Cyclin-dependent kinase 4 and 6 inhibitor.  Cyclin D1, CDK4, and CDK6 are downstream of signaling pathways which result in cellular proliferation.  The use of palbociclib with antiestrogens was observed to increase growth arrest in estrogen receptor (ER)-positive breast cancer cell lines by decreasing retinoblastoma protein (Rb) phosphorylation, which resulted in reduced E2F expression and signaling.  Palbociclib has been observed to cause cell cycle arrest between G1 to S phase of the cell cycle in ER-positive breast cancer cell lines.<ref name=insert>[http://labeling.pfizer.com/ShowLabeling.aspx?id=2191 Palbociclib (Ibrance) package insert]</ref><ref>[[Media:Palbociclib.pdf|Palbociclib (Ibrance) package insert (locally hosted backup)]]</ref><ref>[http://www.ibrance.com/ Ibrance manufacturer's website]</ref><ref>Vaughn DJ, Hwang W, Lal P, Rosen MA, Gallagher M, O'Dwyer PJ. Phase 2 trial of the cyclin-dependent kinase 4/6 inhibitor palbociclib in patients with retinoblastoma protein-expressing germ cell tumors. Cancer. 2014 Dec 18. [Epub ahead of print] [http://onlinelibrary.wiley.com/doi/10.1002/cncr.29213/full link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/25522918 PubMed]</ref>
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Class/mechanism:  Cyclin-dependent kinase 4 and 6 inhibitor.  Cyclin D1, CDK4, and CDK6 are downstream of signaling pathways which result in cellular proliferation.  The use of palbociclib with antiestrogens was observed to increase growth arrest in estrogen receptor (ER)-positive breast cancer cell lines by decreasing retinoblastoma protein (Rb) phosphorylation, which resulted in reduced E2F expression and signaling.  Palbociclib has been observed to cause cell cycle arrest between G1 to S phase of the cell cycle in ER-positive breast cancer cell lines.<ref name=insert>[http://labeling.pfizer.com/ShowLabeling.aspx?id=2191 Palbociclib (Ibrance) package insert]</ref><ref>[[:File:Palbociclib.pdf|Palbociclib (Ibrance) package insert (locally hosted backup)]]</ref><ref>[http://www.ibrance.com/ Ibrance manufacturer's website]</ref>
 
<br>Route: PO
 
<br>Route: PO
 
<br>Extravasation: n/a
 
<br>Extravasation: n/a
  
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [http://online.lexi.com/ Lexicomp], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the package insert.<ref name="insert"></ref>
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For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [http://online.lexi.com/ Lexicomp], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the package insert.<ref name="insert"></ref>
  
 
==Diseases for which it is used==
 
==Diseases for which it is used==
*[[Breast cancer]]
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*[[Breast cancer, ER-positive]]
  
 
==Patient drug information==
 
==Patient drug information==
 
*[http://labeling.pfizer.com/ShowLabeling.aspx?id=2191 Palbociclib (Ibrance) package insert]<ref name="insert"></ref>
 
*[http://labeling.pfizer.com/ShowLabeling.aspx?id=2191 Palbociclib (Ibrance) package insert]<ref name="insert"></ref>
*[http://chemocare.com/chemotherapy/drug-info/palbociclib.aspx Palbociclib (Ibrance) patient drug information (Chemocare)]<ref>[http://chemocare.com/chemotherapy/drug-info/palbociclib.aspx Palbociclib (Ibrance) patient drug information (Chemocare)]</ref>
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*[https://chemocare.com/druginfo/palbociclib.aspx Palbociclib (Ibrance) patient drug information (Chemocare)]<ref>[https://chemocare.com/druginfo/palbociclib.aspx Palbociclib (Ibrance) patient drug information (Chemocare)]</ref>
 
*[http://www.uptodate.com/contents/palbociclib-patient-drug-information Palbociclib (Ibrance) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/palbociclib-patient-drug-information Palbociclib (Ibrance) patient drug information (UpToDate)]</ref>
 
*[http://www.uptodate.com/contents/palbociclib-patient-drug-information Palbociclib (Ibrance) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/palbociclib-patient-drug-information Palbociclib (Ibrance) patient drug information (UpToDate)]</ref>
  
 
==History of changes in FDA indication==
 
==History of changes in FDA indication==
*2/3/2015: [http://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm432886.htm Accelerated FDA approval] to be used "in combination with [[Letrozole (Femara) | letrozole]] for the treatment of postmenopausal women with estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced [[Breast_cancer|breast cancer]] as initial endocrine-based therapy for their metastatic disease."
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*2015-02-03: [http://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm432886.htm Accelerated FDA approval] to be used in combination with [[Letrozole (Femara) | letrozole]] for the treatment of postmenopausal women with [[Biomarkers#ER|estrogen receptor (ER)]]-[[Biomarkers#Expression|positive]], [[Biomarkers#HER2|human epidermal growth factor receptor 2 (HER2)]]-[[Biomarkers#Normal_expression|negative]] advanced [[Breast_cancer|breast cancer]] as initial endocrine-based therapy for their metastatic disease. ''(Based on PALOMA-2)''
*2/19/2016: FDA approval expanded "in combination with [[Fulvestrant (Faslodex)|fulvestrant]] for the treatment of women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer with disease progression following [[Breast_cancer#Metastatic_disease.2C_endocrine_therapy|endocrine therapy]]."
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*2016-02-19: FDA approval expanded in combination with [[Fulvestrant (Faslodex)|fulvestrant]] for the treatment of women with [[Biomarkers#HR|hormone receptor (HR)]]-[[Biomarkers#Expression|positive]], [[Biomarkers#HER2|human epidermal growth factor receptor 2 (HER2)]]-[[Biomarkers#Normal_expression|negative]] advanced or metastatic [[breast cancer]] with disease progression following endocrine therapy. ''(Based on PALOMA-3)''
*3/31/2017: FDA approval expanded "for the treatment of hormone receptor (HR) positive, human epidermal growth factor receptor 2 (HER2) negative advanced or metastatic breast cancer in combination with an aromatase inhibitor as initial endocrine based therapy in postmenopausal women."<ref name="insert"></ref>
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*2017-03-31: Granted regular approval for the treatment of [[Biomarkers#HR|hormone receptor (HR)]] [[Biomarkers#Expression|positive]], [[Biomarkers#HER2|human epidermal growth factor receptor 2 (HER2)]] [[Biomarkers#Normal_expression|negative]] advanced or metastatic [[breast cancer]] in combination with an aromatase inhibitor as initial endocrine based therapy in postmenopausal women. ''(Based on PALOMA-2)''
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==History of changes in EMA indication==
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*2016-11-09: Initial authorization
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==History of changes in Health Canada indication==
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*2016-03-16: Initial notice of compliance with conditions
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*2016-11-17: Conditions were met
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==History of changes in PMDA indication==
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*2017-09-27: New approval for the treatment of unresectable or recurrent [[breast cancer]].
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*2020-01-23: New indication in a new dosage form for the treatment of hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative inoperable or recurrent [[breast cancer]].
  
 
==Also known as==
 
==Also known as==
PD-0332991
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*'''Code name:''' PD-0332991
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*'''Brand names:''' Ibrance, Lucipalb, Palbace, Palbocap, Palbocent, Palbonix
  
 
==References==
 
==References==
 
<references/>
 
<references/>
  
[[Category:Drug index]]
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[[Category:Drugs]]
[[Category:Chemotherapy]]
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[[Category:Oral medications]]
[[Category:Oral chemotherapy]]
 
  
[[Category:Enzyme inhibitors]]
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[[Category:Protein expression-specific medications]]
[[Category:Kinase inhibitors]]
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[[Category:CDK4 inhibitors]]
[[Category:CDK inhibitors]]
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[[Category:CDK6 inhibitors]]
  
 
[[Category:Breast cancer medications]]
 
[[Category:Breast cancer medications]]
[[Category:Drugs FDA approved in 2015]]
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[[Category:FDA approved in 2015]]
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[[Category:EMA approved in 2016]]
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[[Category:Health Canada approved in 2016]]
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[[Category:PMDA approved in 2017]]

Revision as of 23:29, 2 September 2023

General information

Class/mechanism: Cyclin-dependent kinase 4 and 6 inhibitor. Cyclin D1, CDK4, and CDK6 are downstream of signaling pathways which result in cellular proliferation. The use of palbociclib with antiestrogens was observed to increase growth arrest in estrogen receptor (ER)-positive breast cancer cell lines by decreasing retinoblastoma protein (Rb) phosphorylation, which resulted in reduced E2F expression and signaling. Palbociclib has been observed to cause cell cycle arrest between G1 to S phase of the cell cycle in ER-positive breast cancer cell lines.[1][2][3]
Route: PO
Extravasation: n/a

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the package insert.[1]

Diseases for which it is used

Patient drug information

History of changes in FDA indication

History of changes in EMA indication

  • 2016-11-09: Initial authorization

History of changes in Health Canada indication

  • 2016-03-16: Initial notice of compliance with conditions
  • 2016-11-17: Conditions were met

History of changes in PMDA indication

  • 2017-09-27: New approval for the treatment of unresectable or recurrent breast cancer.
  • 2020-01-23: New indication in a new dosage form for the treatment of hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative inoperable or recurrent breast cancer.

Also known as

  • Code name: PD-0332991
  • Brand names: Ibrance, Lucipalb, Palbace, Palbocap, Palbocent, Palbonix

References