Palbociclib and letrozole in hormone-receptor positive advanced breast cancer: Predictive response and prognostic factors

Mohamad Ali Salloum, PharmD • October 13, 2022

Share

  • Slide title

    Write your caption here
    Button
  • Slide title

    Write your caption here
    Button
  • Slide title

    Write your caption here
    Button
  • Slide title

    Write your caption here
    Button

I am glad to announce that a new article was published on June 2022 in the journal "Current Problems in Cancer" which I participated in as a co-author. I wish you a joyful reading of the abstract below!

Abstract

CDK 4/6 inhibitors have been yielding propitious results when with hormone therapy in the management of Her2-negative and hormone-receptor (HR)-positive metastatic breast cancer, Palbociclib being one of the first molecules investigated in this setting. However, the response to CDK4/6 inhibitors is variable. To identify predictive and prognostic factors of response to this therapeutic regimen.

Eligible patients were females with HR+ and Her2- advanced breast cancer, receiving Palbociclib in combination with Letrozole. PFS was the primary endpoint in the evaluation of response to treatment. This survival was then further segregated according to various characteristics: histological (type, grade, hormone receptors), metastatic site, line of treatment, response type at initial assessment, and best response achieved. The data was then processed by two statistical analysis models: Kaplan-Meier and univariate preceding multivariate Cox proportional risks.

Sixty patients were included and followed for a median follow-up duration of 15.98 months. PFS recorded a median of 19.07 months (95% CI=15.43-22.71). PFS had a median of 12.99 months in the absence of progesterone receptors (vs 20.05 months in the case of positive estrogen and progesterone receptors; P = 0.046), a median of 13.02 months in the presence of liver metastases (vs 22.98 months in the absence of liver metastases; P = 0.007), and 15.94 months in the case of second-line and beyond (vs 22.98 months in the case of first-line; P = 0.033). Regarding the Hazard Ratio of progression, we note age (HR 0.941; P = 0.019), liver metastases (HR 2.751; P = 0.051), response at initial evaluation (HR<1; P < 0.001) and best response (HR<1; P = 0.003). PFS reached similar figures to those of international studies. The absence of progesterone receptors, the presence of liver metastases, and use as second-line or beyond are associated with a reduced median PFS. One year age increase (protective factor), liver metastases (risk factor), response at initial evaluation, and best response achieved are identified as the most predictive factors of the response to this treatment regimen and of the progression risk.

Copyright © 2022. Published by Elsevier Inc.

The article was in collaboration with:

Khalil El Gharib (1)Walid Macaron (2)Joseph Kattan (2)Mohamad Ali Salloum (3)Fadi Farhat (3)Marianne Smith (4)Fadi El Karak (2)

Affiliations

1) Department of Medicine, Staten Island University Hospital, Staten Island, New York. Electronic address: khalil.gharib@outlook.com.

2) Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.

3) Hammoud Hospital University Medical Center, Saida, Lebanon.

4) Department of Medicine, Staten Island University Hospital, Staten Island, New York.


Resources:

1) Gharib KE, Macaron W, Kattan J, Salloum MA, Farhat F, Smith M, Karak FE. Palbociclib and letrozole in hormone-receptor positive advanced breast cancer: Predictive response and prognostic factors. Curr Probl Cancer. 2022 Jun;46(3):100859. doi: 10.1016/j.currproblcancer.2022.100859. Epub 2022 Mar 28. PMID: 35378469.

List of Services

    • Slide title

      Write your caption here
      Button
    • Slide title

      Write your caption here
      Button
    • Slide title

      Write your caption here
      Button
    • Slide title

      Write your caption here
      Button

    ABOUT THE AUTHOR

    Mohamad-Ali Salloum, PharmD

    Mohamad Ali Salloum LinkedIn Profile

    Mohamad-Ali Salloum is a Pharmacist and science writer. He loves simplifying science to the general public and healthcare students through words and illustrations. When he's not working, you can usually find him in the gym, reading a book, or learning a new skill.

    Share

    Recent articles:

    By Mohamad-Ali Salloum, PharmD March 8, 2026
    A clear, engaging walkthrough of fentanyl’s pharmacokinetics and pharmacodynamics—from administration to metabolism and excretion—designed for pharmacy and medical students, with visuals, summaries, and an interactive quiz.
    By Mohamad-Ali Salloum, PharmD March 7, 2026
    Learn about Buprenorphine, the strong gripper, but weak pusher 😅
    By Mohamad-Ali Salloum, PharmD March 7, 2026
    References : American Chemical Society. Tramadol – Molecule of the Week Archive. December 16, 2014. [acs.org] DEA Diversion Control Division. Tramadol Drug & Chemical Evaluation Section Report. April 2025. [deadiversi....usdoj.gov] Grond S, Sablotzki A. Clinical pharmacology of tramadol. Clin Pharmacokinet. 2004;43(13):879‑923. [go.drugbank.com] Food and Drug Administration (FDA). ULTRAM® (tramadol hydrochloride) tablets label. 2004. [accessdata.fda.gov] Nickson C. Tramadol – CCC Pharmacology. Life in the Fast Lane ; 2024. [litfl.com] DrugBank Online. Tramadol: Uses, Interactions, Mechanism of Action. DB00193. [go.drugbank.com] Food and Drug Administration (FDA). Tramadol Hydrochloride Tablets (DailyMed). 2023. [dailymed.nlm.nih.gov] Dean L. Tramadol Therapy and CYP2D6 Genotype. Medical Genetics Summaries . 2015. [ncbi.nlm.nih.gov] Food and Drug Administration (FDA). Tramadol ER Capsules Label Information. 2010. [accessdata.fda.gov] EBM Consult. Mechanism for Tramadol‑Induced Serotonin Syndrome in Patients Taking SSRIs. 2017. Medsafe Pharmacovigilance. Serious Reactions with Tramadol: Seizures and Serotonin Syndrome. 2007. Hassamal S, Miotto K, Dale W, Danovitch I. Tramadol: Understanding the Risk of Serotonin Syndrome and Seizures. Am J Med. 2018;131(11):1382.e1–6. Medscape Reference. Ultram, ConZip (tramadol) dosing, indications, interactions. 2026.
    By Mohamad-Ali Salloum, PharmD March 5, 2026
    A thoughtful reflection on Declutter Your Mind, exploring mental clutter, awareness, negative thinking patterns, mindfulness, and practical habits for mental clarity.
    By Mohamad-Ali Salloum, PharmD February 27, 2026
    References: Qiang S, Wu J, Zheng D, et al. The effect of stress mindset on psychological pain: the chain mediating roles of cognitive reappraisal and self-identity. Front Psychol. 2025;16. 1 Bosshard M, Gomez P. Effectiveness of stress arousal reappraisal and stressisenhancing mindset interventions on task performance outcomes: a meta-analysis. Sci Rep. 2024. 2 Zhao S, Chen P, Jin L, et al. Unlocking Emotional Well-Being: Evaluation of a Stress Mindset Intervention With a Metacognitive Approach. Emotion. 2025;25(5):1169–1184. 4 Meyer HH, Stutts LA. The Effect of Mindset Interventions on Stress and Academic Motivation in College Students. Innov High Educ. 2024;49:783–798. 7 Crum AJ, Santoro E, Handley-Miner I, et al. Evaluation of the “Rethink Stress” Mindset Intervention: A Metacognitive Approach to Changing Mindsets. J Exp Psychol Gen. 2023. 3 Laferton JAC, Fischer S, Ebert DD, et al. The Effects of Stress Beliefs on Daily Affective Stress Responses. Ann Behav Med. 2020;54(4):258–267. 5 UCSF Stress Measurement Network. Beliefs about Stress . 2026. 6
    By Mohamad-Ali Salloum, PharmD February 24, 2026
    References: Qiang S, Wu J, Zheng D, et al. The effect of stress mindset on psychological pain: the chain mediating roles of cognitive reappraisal and self-identity. Front Psychol. 2025;16. 1 Bosshard M, Gomez P. Effectiveness of stress arousal reappraisal and stressisenhancing mindset interventions on task performance outcomes: a meta-analysis. Sci Rep. 2024. 2 Zhao S, Chen P, Jin L, et al. Unlocking Emotional Well-Being: Evaluation of a Stress Mindset Intervention With a Metacognitive Approach. Emotion. 2025;25(5):1169–1184. 4 Meyer HH, Stutts LA. The Effect of Mindset Interventions on Stress and Academic Motivation in College Students. Innov High Educ. 2024;49:783–798. 7 Crum AJ, Santoro E, Handley-Miner I, et al. Evaluation of the “Rethink Stress” Mindset Intervention: A Metacognitive Approach to Changing Mindsets. J Exp Psychol Gen. 2023. 3 Laferton JAC, Fischer S, Ebert DD, et al. The Effects of Stress Beliefs on Daily Affective Stress Responses. Ann Behav Med. 2020;54(4):258–267. 5 UCSF Stress Measurement Network. Beliefs about Stress . 2026. 6
    By Mohamad-Ali Salloum, PharmD February 14, 2026
    A clear, evidence‑based guide to Ramadan fasting, explaining its metabolic, mental, and cardiometabolic benefits, plus practical nutrition, hydration, sleep, and medication strategies for healthy adults and high‑risk patients.
    By Mohamad-Ali Salloum, PharmD February 13, 2026
    A practical guide to shifting from blaming “human error” to applying ICH GCP E6(R3) system‑level quality, Quality by Design, and risk‑based oversight to prevent repeat deviations in clinical trials.
    By Mohamad-Ali Salloum, PharmD February 10, 2026
    Learn 5 Whys and Fishbone (Ishikawa) for Root Cause Analysis in clinical research, with practical examples and an interactive quiz—no fluff, just clarity.
    By Mohamad-Ali Salloum, PharmD February 9, 2026
    A clear, practical guide to CAPA for Clinical Research Associates—covering corrective and preventive actions, real‑world scenarios, and an interactive quiz to reinforce learning.
    More Posts