Medical Information

Palociclib is a CDK4/6 inhibitor, mainly used for the treatment of advanced breast cancer with hormone receptor positive and HER2 negative. Its indications are clearly targeted at patients with specific molecular subtypes, and when using medication, special attention should be paid to blood toxicity, infection risk, and management of special populations. The following items provide specific details.

1. Indications

(1) Combined aromatase inhibitor (such as letrozole) as the initial endocrine therapy for HR+/HER2 advanced breast cancer in postmenopausal women.

(2) Combined with Fluvastatin for the follow-up treatment of HR+/HER2 advanced breast cancer patients after the progress of endocrine therapy.

2. Medication precautions

(1) Hematological toxicity

Common neutropenia may lead to infection. Blood routine examination is required before treatment, with monitoring every 2 weeks for the first two cycles and regular follow-up examinations. When grade 3-4 neutropenia occurs, medication should be suspended until recovery.

(2) Risk of infection

During the period of neutropenia, close monitoring of signs of infection is necessary. Avoid contact with patients with active infections. If symptoms of infection such as fever occur, seek medical attention immediately.

(3) Hepatotoxicity

Regular liver function tests should be conducted before and during treatment. When ALT/AST>3 times ULN or bilirubin>1.5 times ULN, administration should be suspended and reduced after recovery.

(4) Embryo fetal toxicity

May cause fetal damage, women of childbearing age need to confirm their pregnancy status before taking medication. Efficient contraceptive measures should be taken during the treatment period and within 3 weeks after the last dose.

(5) Drug interactions

CYP3A potent inhibitors (such as clarithromycin) may increase the blood concentration of pembrolizine and should be avoided in combination or the dosage adjusted. Inducing agents (such as rifampicin) may reduce efficacy.

(6) Lactation period

Medications may be secreted into breast milk, and breastfeeding should be stopped during the treatment period and within 3 weeks after the last administration.

(7) Special populations

Mild to moderate cases of liver dysfunction do not require dose adjustment, and severe cases (Child Pugh C) should be used with caution. Mild to moderate renal insufficiency does not require adjustment, and there is a lack of data on end-stage renal disease.