Ibrance (Palbociclib)
Comments
-
Radagast...good news is always welcome. I say "Celebrate the small joys!"
Husband, glad the hospital has got a handle on your wife's troubles. Still sad you can't be with her and Monday is a long time, but a picture from a grandchild should help a lot!
0 -
I'm thinking of you and really feel for you husband11. Good luck to you both.
0 -
Husband11...so sorry to hear about what your wife is dealing with. She's in my thoughts and prayers.
Miss Rabbit...great news on the lower TM's!
Regarding the new Ibrance pills. I am on 100mg and the pill (it's a light green) is actually smaller than the capsule. I keep mine in the blister pack. The one thing that bothers me a little is the smell. It definitely has an odor. Also, it seems like it leaves an aftertaste but that might be my imagination as I've only been on it since this past Monday.
0 -
Husband 11– hugs and prayers to you both. May your wife do well and be able to leave the hospital. Hoping you will see your wife very soon
0 -
Does anyone know if letrozole or palbo can increase the risk of stomach ulcers? Or is this completely unrelated? Any increased risk associated with breast cancer, or liver metastasis?
0 -
Husband 11 sore I don’t know the answer to your question. I’m glad your wife is getting good care and got a special delivery watercolor to boot. So heartwarming and thoughtful.
Tanya
0 -
Husband I don’t know either though I wouldn’t be surprised. SO many weird side effects. But I’m really happy you got that care package to her and report she is being treated well! 😊
Not a big deal but I myself ended up at the hospital today for about five hours. After they told me the good news that my count was 1.2 they said I needed to wait to be tested for COVID-19 because I couldn’t start my next cycle without that. Anyone else have that happen to them?
0 -
Rabbit- Woohoo for the lowered TM's !!!
Dodgers- What is the date of your scan? I try to keep track of everyone's upcoming scans/appts.
Husband- Thinking of you and your wife. Sounds like she is in good hands.
Penny- I have not been in the hospital, but have not been told to check for COVID before next Ibrance cycle. And some have posted that they are holding Ibrance in this day of COVID. My MO has not held the med either.
0 -
-
Cure-ious,
I just saw this on the weekly feed from Practice Update/Elsevier. It sounds like although this drug is being used in other cancers, it is just now being tested in a Phase I trial with respect to using it with BC and the CDK4/6 drugs. Interesting concept, but again -- when will it come through for any of us?
0 -
Interesting article Cure-ious. If like BevJen said that this is being used already in other cancers, would they be able to speed up the trials for BC since they already have more information on the drug?
0 -
That's great news Cure-ious...thanks for posting! How great would it be if this drug works?!!!
0 -
Husband - I hope your wife can be home ASAP. I’m sorry that you have to be apart.
Went to the hospital masked up and used hand sanitizer at every opportunity. I didn’t have to wait long to get my blood drawn and see my MO, but my lab results weren’t complete until I arrived home. My CA 15-3 dropped from 270 to 162 over 2 months. All time high was 1386. Have ongoing fatigue and rash on neck. Due to low ANC, MO said to delay cycle #5 (125 mg) by a week.
0 -
Anyone have any experience with proton pump inhibitors and palbociclib? For the old version, the capsules, the monograph is clear as mud. It shows some effect, then goes on to talk about H2 inhibitors. So are they saying H2 agonists are preferred to PPI's?
From Pfizer:
Capsules: Data from a study in healthy subjects indicated that coadministration of a single 125 mg IBRANCE capsule with multiple doses of the PPI rabeprazole under fed conditions decreased palbociclib Cmax by 41%, but had limited impact on AUCinf (13% decrease) compared with a single 125 mg IBRANCE capsule administered alone. Given the reduced effect on gastric pH of H2 receptor antagonists and local antacids compared to PPIs, the effect of these classes of acid reducing agents on palbociclib exposure under fed conditions is expected to be minimal.
Data from another study in healthy subjects indicated that coadministration of a single 125 mg IBRANCE capsule with multiple doses of the PPI rabeprazole under fasted conditions decreased palbociclib AUCinf and Cmax by 62% and 80%, respectively, when compared with a single 125 mg IBRANCE capsule administered alone.
IBRANCE capsules should be taken with food.
0 -
Husband,
SH** -- pardon my French. I have been taking omeprazole (PPI) for a number of years. I'm thinking now, though, that we may have had a previous discussion about this on BCO, but I can't quite remember.
I do know that when I was reading up on Piqray, which could likely be my next drug, I read something that said NO to omeprazole and that drug.
0 -
BevJen,
It sounds like the new tablets will address this problem, but they are not yet being distributed in Canada.
0 -
Thought I would drop a line to say hello. Moving on to cycle 30 next week. Things are going well and I'm feeling pretty good most days. My count soared from the usual 1 to 3.5 after my personal request of having an extra week break from Ibrance.
I follow each of your stories and have kept you all in my thoughts and prayers. Husband11, hope your wife recovers quickly and will soon be back in course with treatments.
Don't know why but feeling uneasy these days. Not sure it's because of the recent death of a friend who was the first person I spoke to about MBC when I was first diagnosed 2.5 years ago. It could also be an upcoming scan in June causing some anxiety. I kept on asking myself, why am I coughing? Why am I losing weight? I can't help but reviewing some of the stories of people on this board who's light burnt out way too soon and too quickly. I guess uncertainty comes along this cancer territory. However, no different from the current covid situation effecting millions of lives around the world.
On days like this I aimlessly search on the internet looking for some words of encouragement and hope. Maybe you have some some stories of inspiration to share.
I did a painting in celebration of Mother's Day this weekend. Bluejays are one of my favorite birds as I am often mesmerized by its elegance, beauty and fierce characteristic. I thought I would share this photo to wish all the mothers, grandmothers on this forum a Happy Mother's day.
0 -
Husband, I have been on Ibrance and Omeprazole for four years with good success until now. I took the omeprazole in the morning and Ibrance 125 at night with food. I tried to go off the omeprazole several times but had too much gerd pain. I tried switching to Pepcid but it didn't work for me. My onc told me to stay on the omeprazole.
0 -
Thanks IntoLight
Were you on the omeprazole while you determined the correct dose for Ibrance? Ie, if it was taken before you started ibrance, the trial and error of determining dosage would take into account your rate of absorption. The problem I see is for women like my wife, who have already settled on a dose of ibrance, 75mg in her case, and now the effective dosage will be lowered 13%. Hopefully, that isn't significant.
Thereishope; that is beautiful! I love seeing Bluejays.
0 -
Thereishope4us, I know what you mean -- I'm having one of those days too. I will say your lovely painting put a smile on my face. :-)
Candy, my COVID-19 results just came back negative so I'm on to cycle 41. They just told me that I'll need to be tested monthly before I can begin a new cycle! My onc (who is a researcher at a large hospital in NYC) said that new data is showing that cancer doesn't make us more susectible to COVID but our "outcomes" are worse. :-(
On that note,
Hugs,
Penny
P.S. Extra hugs to Husband11 -- thinking of you!
0 -
Husband, right, clear as mud. I read it several times and came away with the impression that the trial had patients taking Ibrance and the PPI at the same time on an empty stomach. Like Chris, I take the PPI before breakfast on an empty stomach and Ibrance with dinner. I've taken a PPI for probably 20 years on and off, adjusting dose and schedule. My Ibrance dose was reduced while taking the PPI. Lately, I have been having issues when I take TOO MUCH of the PPI. I take 10 mg of Prilosec, have for years. I was having break through gastritis pain and went up to 20 mg. I had breakthrough pain again and went up to 30 mg. Then I noticed yeast overgrowth in various locations (thrush, vaginal yeast and overall bad GI feeling which I think is related to yeast) and I'm treating that now. Still experimenting. It makes sense that lowering acid would lead to yeast. I've been meaning to bring this up here for a while since several people here take a PPI. Sorry, Husband for wandering off topic. I wish the Pfizer info was written so a person could understand it. Why do they have to write around in circles like that? I had to look up "fed conditions."
0 -
Unfortunately the particular ppi they want her on, is taken twice a day. So that rules out any significant effect from staggering it from the daily ibrance.
0 -
Glad the painting made you smile Penny. Happy to hear that the covid testing came back negative. I look up to your cycle 41. Hope we stay stable on this for a long time.
0 -
Husband, my onc prescribed both Ibrance 125mg and omeprazole at the same time because of my slight gerd symptoms at the time and according to her experience. My Ibrance dosage has never changed. Chris
0 -
Husband,
I emailed the NP at my center -- she said it was fine to do omeprazole so long as it's separated y 2 hours from the Ibrance. Don't know if that helps or not....
0 -
BevJen,
This drug inhibits the BCl2 protein, which is over-expressed in 70-80% of ER-positive MBCs. Basically this study suggests using Venetoclax to kill the cancer cells that Ibrance so effectively puts to rest. Side effects are mostly lymphopenia/neutropenia/infections, occasional low grade nausea from taking all of the pills (they picked the highest dose to test, of course, even thought they saw that a 400mg dose also worked), plus you have to drink a lot of water because of tumor lysis syndrome, which is when the massive cancer cell die-off is hard on your kidneys. Sounds like a reasonable trade-off, instead of just sitting around taking Ibrance, we could be killing off those sleeping beauties!
For 24 patients treated at the 800mg dose in their phase one trial (where it was combined with tamoxifen), the radiologic overall response rate was 54% and the clinical benefit rate (CBR; that means those who got at least six months stable disease) was 75%. Treatment-related,high-grade adverse events were infrequent; mostly low-grade cytopenias.
Happily there is a phase two trial ongoing, called VERONICA, which is for BCL-2-positive, ( ER+, HER2- ) MBC patients who have progressed on a CDK4/6 inhibitor and are moving to second or third-line treatment, where they will get Fulvestrant with or without 800 mg of Venetoclax. Note that no CDK4,6 inhibitor is given in this trial, but study patients must have had 8 weeks or more of a prior CDK4,6 inhibitor. I guess they have to first test the combination with estrogen inhibition, then later test it with CDK4,6 inhibition? Or maybe the prior CDK4,6 inhibtion was enough to put those cells to sleep? They never explain the reasoning of how these trials are designed. No prior Fulvestrant is allowed.
Here is a more detailed description of the trial:
https://ascopubs.org/doi/abs/10.1200/JCO.2019.37.1...
Here is a link to the trial:https://clinicaltrials.gov/ct2/show/NCT03584009
Trial sites are also available in Canada (Quebec), Germany, UK*Not being offered at UCSF, Memorial Sloan-Kettering or MD Anderson, perhaps it is still too early to interest the cancer bigshots? Hopefully we will hear interim results at ASCO, ESMO, or San Antonio
0 -
Cure-ious that's fascinating and encouraging. Thanks for sharing! I so vividly remember our hopeful exchanges on this Board about alpelisib -- what was it -- almost two years ago? I've heard very little about how well "Piqray" is working in the real world. Are you?
thereishope4us, yes the painting was lovely! I'm so glad you shared it. And yes, I'm SO happy to be COVID-19 negative. I wasn't really worried until they said I need to be tested. And then suddenly I was!
Hugs,
Penny
0 -
Some years ago when I took Femara I had terrible acid reflux and took Prilosec which helped a lot until I tried to cut back or stop the drug. Then, oh my goodness!
I was determined to find a way to get better naturally and followed a local naturopath's Leaky Gut Diet for some time. I finally discovered that just eating gluten-free made a world of difference.
Hope that might be helpful for some of you.
How did I miss Thereishope's Bluejay painting?! Bring it back!
Love from PatGMc
0 -
Cure-ious - my H is a study site for the UK and the drug has already been approved for use by the national board here for treating leukemia, so I wonder if that means it would have a chance to be fast tracked if the combination works. I remember thinking when they were going over the CDK inhibitor and letrozole well, sure that sounds great and all but what, the cancer isn't actually being killed? I usually don't pay too close of attention to studies as Im not near the point of needing a study yet, and most of the latest ones seem to be for the TN ladies, but this one has certainly piqued my interest and I will keep it tucked in the back of mind. Thanks!
0 -
Sondra- I think the prior experience with Venetoclax might have accellerated phase one, where they tested if Venetoclax is safe in combination with tamoxifen (even though it is known to be safe they still have to show the combination is safe) now phase two to see if it is effective.
For Ibrance, the results were so strong that as soon as phase three trials were fully enrolled, the FDA made the drug available to everybody, contingent still on collecting the phase three data but at least we didn't have to wait for that. For this trial, the phase two is scheduled to be done Feb 2022, and often it seems these trials wrap up a bit before the end date (at least stop collecting data and go on to schedule phase three? Does anybody know how these trials are run, I have no idea)
So possibly it could have good results and its clear and they start in enrolling for phase three and once its full we get the drug? I think whether you are taking it for secondline with faslodex, or after chemo when you are hoping it is sensitive to estrogen again, the combo would be attractive. But my high bar is whatever will not cause me to lose hair, so I'm not so picky...
0
