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Biomarkers

Blood test after taking palbociclib could predict response in advanced breast cancer

Research has shown that testing for PIK3CA levels after taking palbociclib could help predict a progression-free survival, making it the first known biomarker for this therapy.

Woman having a blood test

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Researchers found that changes in PIK3CA circulating tumour DNA levels can help predict progression-free survival in advanced breast cancer patients receiving palbociclib and fulvestrant

Although cyclin-dependent kinase (CDK) 4/6-inhibitors, such as palbociclib and abemaciclib, have been shown to slow disease progression in advanced breast cancer, there are no known biomarkers to predict response to these therapies and women have to wait two to three months to find out if they are working using a scan.

Reporting in Nature Communications (online, 1 March 2018), researchers analysed plasma samples from 73 women with advanced breast cancer carrying a frequently mutated gene (PIK3CA) who took part in a randomised trial of palbociclib added to the endocrine therapy, fulvestrant[1]. They studied the levels of circulating tumour DNA (ctDNA), which is shed from the tumour and found in the bloodstream.

The team found that 15 days after treatment, the change in PIK3CA ctDNA levels strongly predicted progression-free survival for patients receiving palbociclib and fulvestrant (hazard ratio 3.94, 95% confidence interval 1.61–9.64).

They said the results represented the first biomarker for predicting response to palbociclib. In future, early ctDNA levels could be used to determine which patients should have their therapy switched or augmented with adjuvant therapies, the researchers concluded.

Citation: Clinical Pharmacist DOI: 10.1211/CP.2018.20204655

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