Ibrance (Palbociclib)
Comments
-
Hello ladies. I’m about to start Cycle 7 but have received cycle 8 yesterday to put aside till I need it. It was tablets this time. I must say the packaging is much better looking than those plain capsule bottles. Wonder what the tablets will be like? Took a pic so ladies can see. My MO didn’t request the move from capsules to tablets so I guess things are moving that way now.
Husband, so glad your wife is at home with you and all is okay now!!
0 -
I was told by my MO's assistant when I started Ibrance in March that the packaging would soon switch from capsules to tablets. Actually, it makes little difference to me. What does bother me is I'm sure the new, more elaborate packaging costs more money. Gee, I wonder who's paying for it?
After the initial monthly hits of several thousands of dollars, I'm now in the "catastrophic coverage" category of my Medicare Rx plan and this drug is costing me $600+ out of pocket per month .
It better the heck be working.
Tina
0 -
Tina, if you think you might qualify for financial assistance from Pfizer or a foundation, I can give you info. Your MO's office may have already done that. It is easier to qualify than most people think. Just PM me.
0 -
HI Dancers -
I saw my oncologist last friday for blood work/appt and fulvestrant injection. This is the my first completed cycle of 100mg Ibrance so I was hoping my neutrophils would be good. Unfortunately, my neutrophils were lower than on the 125mg on day 25 (.76) so I will redo the blood test this Friday and had to delay my ibrance start. For some reason this really got me down as I had high hopes that the lower dose would not impact my WBC - I consider myself to be healthy (weird as I do have stage IV cancer!) and find this defeating. Like all of us, I have high hopes of both Ibrance working and staying on it for years.
Bluegirl/redstate - I did ask my onc. about Foundation One and she said that they did a panel called UW oncoplex which is similar when I was had my recurrence and that is how they know I don't have the PIK3CA mutation so I guess I dont need the Foundation One test, at this point. She does get a bit uppity about how great the care is at UW/FredHutch/Seattle Cancer Care which is my care center, but I suppose it's good that she is confident? Overall I really like her.
Pat and Thereishope - both of you are such talented artists! Love your work.
I have my 100mg new tablets of Ibrance ready to start, hopefully next week. I have both my early June appts set as well as a pet scan at the end of June. I am getting petscans every 3 months. I don't know how long I will continue to receive petscans quarterly.
Hope everyone is doing well and dancing as much as possible while we self quarantine!
0 -
Great news Husband0
-
aprilgirl - I finished cycle 5 still at 125 mg. My neutrophils are low at 0.6, but my MO wants me to stay at the same dose. I'm taking an extra 4 days off before the next cycle. Think my MO doesn't want to reduce it while my TMs are still high.
0 -
When you all start with the new tablets, let me know if you notice an unpleasant smell.
0 -
JACK5IE-I start them tomorrow, so I'll let you know.
0 -
JACK5IE — yesterday I intentionally paid attention to see if 100 mg Ibrance tablet tasted weird or had a smell. I still noticed nothing. Sorry.
I take mine while eating dinner, mid meal. Not sure if “how” I take Ibrance is impacting smell or taste???
0 -
Hi aprilgirl1, I started on 125g, next month 100g, by the third month 75g as my levels were low and my body was slow to recover. I have been stable, so far, on that dosage for 2 years. There are some on this site who are on the lower dose and have to take a 2 week break between cycles and are doing well. I hope you find a dosage that works for you.
Great news Husband
0 -
JACK5IE-I started cycle 47 today with the new tablets. I didn't notice a smell but there seems to be a bit of an aftertaste that I didn't have with the capsules.
Here's my question for everyone: Why would Pfizer advise us to take the capsules with or without food when their research showed that more Ibrance was absorbed when taken with a high fat meal? The one plus of the new packaging is that the drug information is much easier to read.
For Serenity and others-I have stayed at 125 the whole time. I started out with a lot of cancer. I have found that drinking lots of water and exercising really helps to combat the side effects of fatigue. My ANC is usually pretty low-Grade 3 neutropenia-occasionally I make it up to Grade 2-but since I am rarely sick and able to live an active lifestyle, my MO and I think it is best for me to stay at 125.
0 -
Here's my question for everyone: Why would Pfizer advise us to take the capsules with or without food when their research showed that more Ibrance was absorbed when taken with a high fat meal? The one plus of the new packaging is that the drug information is much easier to read.
Isn't the new formulation to deal with that issue and eliminate the difference between taking it with food or not? Pfizer's research showed that a minority of women who took the old formula (capsules) on an empty stomach absorbed less. For most, it make no difference. Because they can't tell you whether or not it will be an issue for you, they advised everyone to take it with a meal. I understand from Pfizer's website, where they write about the new tablets, that the tablet formulation eliminates the reduced absorption that occurred for some women when they took it on an empty stomach. It also deal with the lower absorption for women on PPI drugs.
EDIT: above isn't entirely accurate. See below post by me with a more detailed version.
0 -
Hello All
I'm having my 1st scans on Tuesday since starting on Ibrance in Jan. Had to wait because of Covid-19 shutdown. I am concerned however because my TMs have not gone down after almost 5 cycles and have basically stayed between my ca15-3 in Jan was 64 then yesterday they were 53.9. My ca 27-29 have gone up and done by few points each time. Started in Jan at 69 yesterday they were at 72. They have gone to 66 at one point. The Onc says the real test is scansbut I do not see a downward trend that I hear others on this tread talking about. I'm so nervous about my scans coming up. I guess I can hope for Stable and not progression. Really thought Ibrance was the right med for me. 😢😢😢😬😬😬😬🙏🙏🙏
0 -
Thanks ladies. I don't know why the smell and taste are bothering me so much with these new tablets while no one else seems to be noticing. 🤔
0 -
Imagine, it took 9 months for my liver mets to get to NEAD via scans on I/L. (I was on AC for 3 months prior due to a critical respiratory situation and became stable.) My tumor marker CA 15.3 slowly went down. Each scan showed improvement. Not everyone can use their TMs to show regression. And the numbers that you stated aren't significantly different. You should look for a trend, not the actual result.
0 -
Thanks Husband. Good to know. I'll have to go to the website myself. I've been taking a handful of nuts everyday with my breakfast to ensure I have enough fat but eliminating that would be a good way of cutting out calories from my diet. I think the nuts have contributed to my weight gain.
0 -
Chicagoan - Good to know. My RBC is dropping with each cycle. Have you been able to keep yours steady?
Imagine - My TM has been dropping but still higher than yours. My MO said not to worry if the drop slows down.
0 -
Here is the info I cut from Pfizer's labeling info on both the capsules (old) vs tablets (new version).
What I said above isn't entirely correct, as it hasn't completely eliminated the relationship between food and absorption.
It would appear there is still a food effect, and a fat content effect, but that is reduced somewhat, and there is no longer a mention of the 13% whose absorption and exposure were very low. Interesting to compare the wording:
First, Capsules:
Food effect: Palbociclib absorption and exposure were very low in approximately 13% of the population under the fasted condition. Food intake increased the palbociclib exposure in this small subset of the population, but did not alter palbociclib exposure in the rest of the population to a clinically relevant extent. Therefore, food intake reduced the intersubject variability of palbociclib exposure, which supports administration of IBRANCE with food. Compared to IBRANCE given under overnight fasted conditions, the population average area under the concentration-time curve from zero to infinity (AUCINF) and Cmax of palbociclib increased by 21% and 38%, respectively, when given with high-fat, high-calorie food (approximately 800 to 1000 calories with 150, 250, and 500 to 600 calories from protein, carbohydrate, and fat, respectively), by 12% and 27%, respectively, when given with low-fat, low-calorie food (approximately 400 to 500 calories with 120, 250, and 28 to 35 calories from protein, carbohydrate, and fat, respectively), and by 13% and 24%, respectively, when moderate-fat, standard calorie food (approximately 500 to 700 calories with 75 to 105, 250 to 350 and 175 to 245 calories from protein, carbohydrate, and fat, respectively) was given 1 hour before and 2 hours after IBRANCE dosing.
Now, Tablets:
Food Effect: The area under the concentration-time curve from zero to infinity (AUCINF) and Cmax of palbociclib increased by 22% and 26%, respectively, when IBRANCE tablets were given with a high-fat, high-calorie meal (approximately 800 to 1000 calories with 150, 250, and 500 to 600 calories from protein, carbohydrate, and fat, respectively), and by 9% and 10%, respectively, when IBRANCE tablets were given with a moderate-fat, standard-calorie meal (approximately 500 to 700 calories with 75 to 105, 250 to 350 and 175 to 245 calories from protein, carbohydrate, and fat, respectively), compared to IBRANCE tablets given under overnight fasted conditions.
0 -
Thanks Husband. I think I will play it safe and continue to take my Ibrance with a high fat meal. Although at my size an 800-1000 calorie meal is a bit extreme but I'll continue to make sure I have some nuts with my cereal or yoghurt.
0 -
Thanks, Husband. Clear as mud. Seems that breakfast may not be the best time to take the pills? As long as I stay on them, I think I'll continue to take them after dinner
0 -
Serenity-My RBC is a little bit low-I am slightly anemic but nothing too serious. I take an iron supplement which I don't think really helps and have been eating more spinach. Hope that yours levels out.
0 -
I would think that consistency would be the most important factor, if that state was in place at the time any dose reduction arrived at. So if you eventually settled on 100 or 75 mg, you would want to continue to do whatever it was you were doing at the time that dose was deemed appropriate for you.
0 -
Happy Friday!!!
The abstracts are now available and can be readily searched online for the ASCO 2020 meeting!! 687 abstracts about metastatic breast cancer.
Here is a link to ASCO 2020 Abstracts: https://meetinglibrary.asco.org/results/metastatic...
Lots of good abstracts, for example there is a phase one report from Hope Rugo (UCSF) who is trying Abemaciclb (Verzenio) with Keytruda (immunotherapy) in patients who are first or secondline with no prior CDK4,6 inhibition- note that no anti-estrogen drugs were included here. Verzenio is the only CDK4,6 inhibitor to have activity on its own, so they are testing if adding Keytruda will make it better.
Because this is phase 1, they are testing for safety and not efficiency, however they do note they seem to be getting more patients responding to the combo than earlier trials with Verzenio alone. Early days still and small numbers of patients, but they do appear to see a jump up in the number who respond and nearly half benefitted with at least stable disease for six months
Excerpt of their abstract:
Of 28 pts enrolled, 15 (54%) received 1 line and 10 (36%) 2 lines of prior systemic chemotherapy in the locally advanced/metastatic setting. Safety of the combination was generally consistent with known side effects of abemaciclib and pembrolizumab and was generally manageable. Grade 3/4 adverse events in >2 pts included neutropenia (8 pts/29%), AST increase (5 pts/18%), diarrhea, and ALT increase (3 pts/11% each). Eight pts had confirmed partial response (29% ORR), and disease control rate (complete response [CR]+partial response [PR]+stable disease [SD]) was 82%. Clinical benefit rate (CR+PR+SD persisting for ≥6 months) was 46%. Median PFS and OS were 8.9 months (95% CI 3.9, 11.1) and 26.3 months (95% CI 20.0, 31.0), respectively. Conclusions: Combination of abemaciclib plus pembrolizumab demonstrated a generally tolerable safety profile with numerically higher rate of transaminase elevations than reported for the individual treatments. Compared to historical data for abemaciclib monotherapy in a similar pt population, a numerically higher but not obviously different ORR, PFS, and OS was observed. Clinical trial information: NCT02779751.
0 -
Thanks, Chicagoan! I'll try to increase my iron intake. My RBC was 3.14 at last check.
0 -
Cure-ious thank you so much for this link. Still no OS info reI/L ☹️
0 -
Good morning ladies!! It has been a while since my last post. I have been trying to keep up with work & family in this crazy time.
Welcome the newbies & praying for those who start next line of treatment after ibrance.
Update on my scan : stable. It has been 15 months for me on Ibrance. Only first two cycles was 100mg, but my body could not handle it, so I asked MO to lower to 75mg and it works to keep my bone mets stable so far.
For those who just started on this med & have difficult times with SE's, please don't hesitate to ask for dose reduction. I was in the same boat 15 months ago, but I was lucky to find this thread & got many good advices from the ladies here. Thanks again for everything.
I just hope this pandemic will be over soon, so we can enjoy a bit of the summer with our loved ones.
Hugs to you all!
0 -
How often do you Ibrance dancers get scans?
Tina
0 -
Hi, Tina,
My MO has me getting a CT with contrast every 3 months. My interventional radiologist, who ablated one of my liver lesions last summer, has me get an MRI of the abdomen every 3 months. My last bone scan, with my prior oncologist, was last May (so a year) although I asked my MO to write an order for another one which she reluctantly did -- but I haven't had that yet because of COVID and not wanting to hang around the hospital which the nuclear tracer makes its way through my body.
Others will reply, I'm sure.
0 -
Tina, my first scan was 4 months, then 3 months for the next two and my last one (2 days ago) was 5 months. My MO never pressured me on scans, so I am the one who decide when to scan, but at least 3 months apart. I hope it helps.
0 -
My neutrophils were up close to 1 so I started cycle 7 of Ibrance (100mg - new tablets).
Jack5ie - I didn't notice any smell or taste with my first one last night at dinnertime.
Tina - I am fairly new to this but my onc has told me to expect quarterly pet scans. I had one mid March and I have my next one scheduled for the last week of June.
Cure-ious - thanks for the info and link!
42Young - 15 months on Ibrance is great, good to hear from you!
Imagine - in your pocket for your scans on Tuesday - please keep us posted:)
Seattle weather was like summer last weekend with 85 degrees and sunny. Today is a cool 60 degrees and drizzly (better weather for staying home I have to say). But, it makes me want to bake pumpkin muffins!
0
