Palbociclib (IBRANCE)

Breast Cancer, advanced or metastatic hormone-receptor positive

Breast Cancer, advanced or metastatic hormone-receptor positive

• Oral: 125 mg once daily on days 1 to 21 out of every 28 days until disease progression or unacceptable toxicity
• Given in combination with fulvestrant or a non-steroidal aromatase inhibitor

Available as 75 mg, 100 mg, and 125 mg tablets or capsules. Capsules contain lactose. Tablets should NOT be crushed or broken. Capsules should NOT be opened. Store at room temperature.

Cyclin-Dependent Kinase (CDK) 4/6 inhibitor

Administration for Tablets: Take with or without food

Administration for Capsules: Take with food

If a dose is missed, patients should be instructed not to take the missed dose but to resume with the next scheduled dose.

Common: Anemia, Neutropenia, Thrombocytopenia, Fatigue, Infection.

Less Common: Pulmonary embolism, Nausea, Diarrhea, Interstitial lung disease/pneumonitis.

The adverse effects listed above are not exhaustive. Please refer to the relevant product monograph for full details.

Baseline before treatment: CBC & differential, platelets, creatinine, ALT, alkaline phosphatase, total bilirubin, GGT, LDH.

During treatment: CBC & differential, platelets, creatinine, (on day 15 of first two cycles check CBC & differential, platelets). After cycle 7 can extend to every third cycle if no neutropenia concerns.

If clinically indicated: ALT, alkaline phosphatase, total bilirubin, GGT, LDH, CA15-3, ECG, serum cholesterol, triglycerides.

• This drug can impact or be impacted by metabolic enzymes for absorption and excretion. Many drugs can also affect or be affected by these enzymes, so please consult with pharmacy to assess for interactions.
• Avoid grapefruit, grapefruit juice, Seville oranges, or Seville orange juice.
• Current drug interaction databases should be consulted for more information.

• Avoid in pregnancy and lactation.
• Neutropenia is a common toxicity. The median duration of ≥ grade 3 neutropenia was 7 days. Febrile neutropenia and neutropenic sepsis have also been reported. Neutropenia is quickly reversible with discontinuation of palbociclib.
• Palbociclib treatment requires patients to be postmenopausal. Patients can be chemically induced into menopause with LHRH agonists.

BC Cancer. BC Cancer Drug Manual. Palbociclib. Vancouver, British Columbia: BC Cancer Agency. Available at: http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Palbociclib_monograph.pdf. Updated September 1, 2020. Accessed January 22, 2024.

Lexicomp. Palbociclib Monograph. In: Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc. Available at: https://online-lexi-com.qe2a-proxy.mun.ca/lco/action/doc/retrieve/docid/patch_f/5526665?cesid=1w9z3KOgX5T&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dpalbociclib%26t%3Dname%26acs%3Dtrue%26acq%3DPalo. Updated January 24, 2024. Accessed January 28, 2024.

Cancer Care Ontario. Palbociclib Monograph. Drug Formulary. Toronto, Ontario: Cancer Care Ontario. Available at: https://www.cancercareontario.ca/en/drugformulary/drugs/monograph/44456. Updated April 2021. Accessed January 22, 2024.

Pfizer Canada Inc. IBRANCE® product monograph. Kirkland, Quebec; 19 May 2017.