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Abstract P1-18-29: Male patients with hormone receptor positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC) receiving palbociclib in the real-world: patient characteristics, treatment patterns, and outcomes from the POLARIS study

2022· article· en· W4220775282 on OpenAlexaboutno aff
Joanne L. Blum, Caroline DiCristo, David J. Gordon, Meghan Karuturi, D. Oubre, Erin Jepsen, Juan Carlos Cuevas, Shailendra Lakhanpal, Zhe Zhang, Yao Wang, Debu Tripathy

Bibliographic record

VenueCancer Research · 2022
Typearticle
Languageen
FieldMedicine
TopicAdvanced Breast Cancer Therapies
Canadian institutionsnot available
Fundersnot available
KeywordsPalbociclibMedicineFulvestrantInternal medicineBreast cancerOncologyCancerNeutropeniaMetastatic breast cancerTamoxifenGynecologyChemotherapy

Abstract

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Abstract Background: Although male breast cancer accounts for <1% of all breast cancer diagnoses, its incidence is increasing. Palbociclib in combination with an aromatase inhibitor or fulvestrant is indicated for treating HR+/HER2- ABC in men. Adding to a previous analysis describing real-world patient characteristics and treatment patterns in men with HR+/HER2- ABC, this analysis describes additional patient characteristics, study site characteristics, and preliminary tumor response data in male patients enrolled in the POLARIS study. Methods: POLARIS is a prospective, noninterventional real-world study of patients with HR+/HER2- ABC who received palbociclib as deemed appropriate by a physician; the targeted enrollment is 1500 patients from approximately 110 US and Canadian sites. Patient and study site data were collected from the treating physicians’ routine clinical assessments (eg, patient medical charts, surveys, site questionnaires). Real-world tumor response was determined based on the treating physicians’ assessments of imaging results and clinical progression. Results: As of December 17, 2020, 15 men were enrolled across 12 US sites; most were community-based sites (75%; Table 1) and most physicians (58.3%) had been treating patients with ABC for 11-20 years. The median age of patients was 66 years, 46.7% of patients had visceral disease, and 41.7% had bone-only disease. Seven patients received palbociclib plus an aromatase inhibitor, 7 patients received palbociclib plus fulvestrant, and 1 patient received palbociclib plus tamoxifen. Two patients initiated palbociclib treatment at 100 mg due to comorbidities. Five patients had ≥1 comorbidity (ie, anemia, neutropenia, cellulitis, myocardial infarction, hypertension, neoplasm, or cerebrovascular disorder). All patients received ≥1 concomitant medications (Table 2). Medications commonly received included antihyperglycemics (53.3%), antidepressants (46.7%), opioids (40.0%), antihyperlipidemics (26.7%), and antithrombotics (26.7%). Among all 15 patients, 1 had a best tumor response of complete response (CR) and 4 patients had a partial response (PR), as reported by the physician. Among patients who received palbociclib in the first-line setting (n=9), 1 had a CR and 3 had a PR, as reported by the physician. Conclusions: These findings add to the current knowledge of the male patient population enrolled in the POLARIS study and provide preliminary information on clinical outcomes. This population represents a real-world patient cohort with a heavy disease burden. Although longer follow-up of this patient cohort is warranted, these results continue to support palbociclib as a treatment for men with HR+/HER2- ABC. Pfizer (NCT03280303). Table 1.US Study Site CharacteristicsSite characteristicSites (N=12), n (%)Geographic locationSouth8 (66.7)Midwest3 (25.0)West1 (8.3)Site categoryCommunity9 (75.0)Academic1 (8.3)Other2 (16.7)Number of treating physicians at the practice*Median (range)12 (3-30)Distribution1-104 (33.3)11-205 (41.7)21-302 (16.7)Not reported1 (8.3)Number of breast cancer cases treated annually†Median (range)350 (50, 3000)Distribution50-1502 (16.7)>1508 (66.7)Not reported2 (16.7)Number of HR+/HER2- A/MBC cases treated annually†Median (range)100 (20, 600)Distribution<503 (25.0)50-1503 (25.0)>1504 (33.3)Missing2 (16.7)Use of clinical pathwaysYes7 (58.3)No5 (41.7)A/MBC=advanced/metastatic breast cancer. *Data missing for 1 site; †data missing for 2 sites. Table 2.Documented Concomitant Medications Received in >10% of Patients*MedicationPatients (N=15), n (%)Antihyperglycemics8 (53.3)Metformin4 (26.7)Glimepiride2 (13.3)Antidepressants7 (46.7)Anxiolytics7 (46.7)Alprazolam4 (26.7)Buspirone2 (13.3)Vitamin A and D, including combinations6 (40.0)Cholecalciferol6 (40.0)Opioids6 (40.0)Procet2 (13.3)Calcium3 (20.0)Other analgesics and antipyretics6 (40.0)Paracetamol3 (20.0)Antiemetics and antinauseants5 (33.3)Prochlorperazine3 (20.0)Ondansetron2 (13.3)Antihyperlipidemics4 (26.7)Atorvastatin2 (13.3)Antithrombotics4 (26.7)Rivaroxaban2 (13.3)Peptic ulcer and GORD medications4 (26.7)Pantoprazole2 (13.3)Thyroid medications3 (20.0)Levothyroxine3 (20.0)Angiotensin II receptor blockers3 (20.0)Losartan3 (20.0)ACE inhibitors2 (13.3)Lisinopril2 (13.3)Low-ceiling diuretics, thiazides2 (13.3)Hydrochlorothiazide2 (13.3)High-ceiling diuretics2 (13.3)Furosemide2 (13.3)Vitamin B12 and folic acid2 (13.3)Cyanocobalamin2 (13.3)Hypnotics and sedatives2 (13.3)Zolpidem2 (13.3)ACE=angiotensin-converting enzyme; GORD=gastro-oesophageal reflux disease.*Specific medications received by >10% of patients; information is entered voluntarily and is subject to missing data. This list is not exhaustive. Citation Format: Joanne Blum, Caroline DiCristo, David Gordon, Meghan Karuturi, David Oubre, Erin Jepsen, Juan Cuevas, Shailendra Lakhanpal, Zhe Zhang, Yao Wang, Debu Tripathy. Male patients with hormone receptor positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC) receiving palbociclib in the real-world: patient characteristics, treatment patterns, and outcomes from the POLARIS study [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-18-29.

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How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Insufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.078
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.001
Science and technology studies0.0010.000
Scholarly communication0.0000.000
Open science0.0010.000
Research integrity0.0000.002
Insufficient payload (model declined to judge)0.0040.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.038
GPT teacher head0.359
Teacher spread0.321 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations1
Published2022
Admission routes1
Has abstractyes

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