Palbociclib (Ibrance)

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

Breast cancer, ER-positive

Patient drug information

History of changes in FDA indication

2015-02-03: Accelerated FDA approval to be used in combination with letrozole for the treatment of postmenopausal women with estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer as initial endocrine-based therapy for their metastatic disease. (Based on PALOMA-2)
2016-02-19: FDA approval expanded in combination with 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 endocrine therapy. (Based on PALOMA-3)
2017-03-31: Granted regular approval 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. (Based on PALOMA-2)

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

[insert-1] 1.0 ^1.1 ^1.2 Palbociclib (Ibrance) package insert

[2] Palbociclib (Ibrance) package insert (locally hosted backup)

[3] Ibrance manufacturer's website

[4] Palbociclib (Ibrance) patient drug information (Chemocare)

[5] Palbociclib (Ibrance) patient drug information (UpToDate)

[1]

[2]

[3]

[4]

[5]