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Care During Chemotherapy and Beyond

Palbociclib

(pal boe SYE klib)

Trade Name: Ibrance®

Palbociclib is the generic name for the trade name drug Ibrance. In some cases, health care professionals may use the trade name Ibrance when referring to the generic drug name palbociclib.

Drug Type:

Palbociclib is a targeted therapy. This medication is classified as a “cyclin-dependent kinase (CDK) 4/6 inhibitor”. (For more detail, see “How Palbociclib Works” below.)

What Palbociclib Is Used For:

  • Palbociclib is used in combination with letrozole (an aromatase inhibitor) to treat postmenopausal women with estrogen receptor (ER) positive, HER2 negative advanced breast cancer.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Palbociclib Is Given:

  • Palbociclib is a capsule. Swallow whole with water. Take within 30 minutes of a meal. Do not break, chew, crush, dissolve or open capsules.
  • Take about the same time each day.
  • Do not eat grapefruit or drink grapefruit juice while on palbociclib.
  • Capsules come in 3 sizes: 75 mg, 100 mg, and 125 mg.
  • If you miss a dose of palbociclib, take it as soon as you remember that day. If you miss taking your dose for the entire day, go back to taking your regular dose the next day. Do not take 2 doses at the same time.
  • The amount of palbociclib that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your exact dosage and schedule.

Side Effects:

Important things to remember about the side effects of palbociclib:

  • Most people will not experience all of the palbociclib side effects listed.
  • Palbociclib side effects are often predictable in terms of their onset, duration, and severity.
  • Palbociclib side effects will improve after therapy is complete.
  • Palbociclib side effects may be quite manageable. There are many options to minimize or prevent the side effects of palbociclib.

The following side effects are common (occurring in greater than 30%) for patients taking palbociclib:

  • Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding.
    • Nadir: 15 days
  • Fatigue
  • Upper respiratory infection

These are less common side effects for patients receiving palbociclib:

  • Nausea
  • Mouth sores
  • Hair loss/thinning
  • Diarrhea
  • Decreased appetite
  • Vomiting
  • Peripheral neuropathy (numbness/tingling of fingers/toes)
  • Weakness
  • Nosebleeds

A rare, but serious side effect of palbociclib is blood clots in the lung (pulmonary embolus (PE)). You should seek emergency help and notify your health care provider immediately if you develop sudden chest pain and shortness of breath. Notify your health care provider within 24 hours if you notice leg or arm swelling, redness, pain and/or skin warm to touch (signs and symptoms of possible blood clot in the arm or leg.)

Not all side effects are listed above. Side effects that are very rare -- occurring in less than about 10 percent of patients -- are not listed here. But you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Fever of 100.4º F (38º C) or higher, chills (possible signs of infection)
  • Sudden chest pain and shortness of breath

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • Nausea (interferes with ability to eat and unrelieved with prescribed medication)
  • Vomiting (vomiting more than 4 times in a 24 hour period)
  • Diarrhea (4 episodes in a 24-hour period)
  • Unusual bleeding or bruising
  • Black or tarry stools, or blood in your stools
  • Blood in the urine
  • Extreme fatigue (unable to carry on self-care activities)
  • Mouth sores (painful redness, swelling or ulcers)
  • Leg or arm swelling, redness, pain and/or warm to touch.

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

  • Before starting palbociclib treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, products containing aspirin unless your doctor specifically permits this.
  • Do not eat grapefruit or grapefruit juice.
  • Do not receive any kind of immunization or vaccination without your doctor’s approval while taking palbociclib.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. This drug must not be given to a pregnant woman or a woman who intends to become pregnant.
  • For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking palbociclib. Barrier methods of contraception, such as condoms, are recommended.
  • Do not breast feed while taking palbociclib.

Self-Care Tips:

  • Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
  • Wash your hands often.
  • To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1 teaspoon of baking soda mixed with 8 ounces of water.
  • Use an electric razor and a soft toothbrush to minimize bleeding.
  • Avoid contact sports or activities that could cause injury.
  • To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
  • Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
  • Get plenty of rest.
  • Maintain good nutrition.
  • Remain active as you are able. Gentle exercise is encouraged such as a daily walk.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing:

You will be checked regularly by your doctor while you are taking palbociclib, to monitor side effects and check your response to therapy. Periodic blood work will be obtained to monitor your complete blood count (CBC).

How Palbociclib Works:

Targeted therapy is the result of about 100 years of research dedicated to understanding the differences between cancer cells and normal cells. To date, cancer treatment has focused primarily on killing rapidly dividing cells because one feature of cancer cells is that they divide rapidly. Unfortunately, some of our normal cells divide rapidly too, causing multiple side effects.

Targeted therapy is about identifying other features of cancer cells. Scientists look for specific differences in the cancer cells and the normal cells. This information is used to create a targeted therapy to attack the cancer cells without damaging the normal cells, thus leading to fewer side effects. Each type of targeted therapy works a little bit differently but all interfere with the ability of the cancer cell to grow, divide, repair and/or communicate with other cells.

There are different types of targeted therapies, defined in three broad categories. Some targeted therapies focus on the internal components and function of the cancer cell. The targeted therapies use small molecules that can get into the cell and disrupt the function of the cells, causing them to die. There are several types of targeted therapy that focus on the inner parts of the cells. Other targeted therapies target receptors that are on the outside of the cell. Therapies that target receptors are also known as monoclonal antibodies. Antiangiogenesis inhibitors target the blood vessels that supply oxygen to the cells, ultimately causing the cells to starve.

Researchers agree that targeted therapies are not a replacement for traditional therapies. They may best be used in combination with traditional therapies. More research is needed to identify which cancers may be best treated with targeted therapies and to identify additional targets for more types of cancer.

Palbociclib (Ibrance®) is a drug that can be used along with an aromatase inhibitor to treat women with advanced hormone receptor-positive breast cancer. Palbociclib is a reversible small molecule cyclin-dependent kinase (CDK) inhibitor. The drug blocks proteins in the cell called cyclin-dependent kinase (CDK) 4 and CDK 6. In hormone positive breast cancer cells, blocking these proteins helps stop the cells from dividing to make new cells. It helps prevent the cells from moving from G1 to S cell cycle phase in the division process. This slows cancer growth. The combination of palbociclib and aromatase inhibitor (e.g. letrozole) is more effective compared with each agent alone.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

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