Ibrance (Palbociclib)
Comments
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Candy, good luck with your MRI.
Aprilgirl1, good luck with your PET scan.
42young, congrats on the stable scan.
NineTwelve, let’s hope your month gets better. Love the avatar.
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SondraF - thank for the suggestion of starchy foods, including starchy vegetables. I'll have to pay more attenton to that even though I feel like might diet does not change much. I was tracking closely what I ate and how much, still write down most of the time, but not as diligently. I do eat lots of pasta and brown rice.
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Candy - I think your switch which opened up the door (so to speak) to 5/2 really was worth it, despite some of the challenges. Its a shame we have to jump through all these hoops to get more dynamic approaches!
BlueGirl - Definitely check on those starches. Also, in these Covid times, I find it way too easy to wander into the kitchen and shove something aimlessly into my mouth, so I guess it tends to add up. I will also note that yesterday I was not feeling gastro great because I'd had too much corn the day before (yeah, ok, it was a grab bag size of Doritos Cool Ranch, Ill own it!), but I also hadn't had a good proper workout in a while so I got on the spin bike to get the heart rate up above what walking does for me. That did the trick and I felt much better after, so potentially consider your exercise level as well.
NineTwelve - I love October but it sure doesn't love me back! Love your TJ Hooker avatar - its one of the first tv shows I can remember watching. That and Mork & Mindy (which I absolutely loathe).
You know, RadgastRabbit hasn't been around for a while - I hope she is doing well.0 -
So, I was due to start cycle 5 of the 125 mg tabs of Ibrance today. Blood work 2 days ago showed my ANC at around .6. A repeat yesterday showed it was around .9. My MO wants me to take a week off and will then lower my dose to 100. I just got my refill of 125, so what am I supposed to do with it? I'll call the specialty pharmacy when they contact me regarding the new dose.
On a "good" note, I was supposed to run downstairs to the lab after I finished my Zometa infusion yesterday. I asked the nurse if she could leave the IV line it, so that they could draw the blood for me using the line she put in and she said, "Oh, I can draw that for you right now." That was so cool because I avoided another stick. She said that they wouldn't use that line anyway for a blood draw (I don't have a port). Anyway, the results were back before I finished the infusion. I'm so glad I asked!
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I had some extra 125. My specialty pharmacy said they would take it back, and give to someone who didn’t have ins or some other problems.
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Spookie's, that would be wonderful if the specialty pharmacy would take it back!
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Cure-ious: As you may recall I have ONJ (osteonecrosis of the jaw). I believe several others on this blog have it also.
I met with my oncologist yesterday. This past weekend he read a paper about a clinical trial for some pills to treat ONJ (non surgical). He said the trial was very positive and didn't know when the FDA would approve for usage but is keeping me informed as to the progress.
I don't know who did the trial (drug company) or the name of the proposed pills. Since I believe you have some resources I do not have to look into this and get a more neutral perspective, I am wondering if you can look into this and see what information is available. Thanks, Jackie
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I've been wondering about Miss Rabbit as well.
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I have osteonecrosis also and would be interested in any new treatment for it. I am on another round of penicillin for a week and a prescription mouthwash. I see the oral surgeon next week to see if there has been any progress in healing. In the meantime my MO has stopped the Xgeva shot completely and I wonder what effect that has on my overall treatment. I am on Fasoldex and Ibrance as well.
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I found a phase 3 clinical trial on ONJ. Is this the one your MO was talking about?
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I don't know any details about the clinical trials for the new ONJ pills. I'll see if I can get more info from my oncologist. I also stopped the Xgeva shots in January based on the recommendation of my oral surgeon and oncologist. Xgeva has a 10 year half life and can stay in your body up to 42 years. I did have a pretty bad fall getting out of the bathtub in February and didn't break anything so I guess it was working for me although I have never in my life had a broken bone. It seems that a lot of us have ONJ so it's more common than I thought it would be.
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Wandering, I was just wondering how you are doing? How is the chemo treating you, and do you know if you are responding yet?
Very interesting that there may be a non-surgical way to treat ONJ, never heard about it so will go read up on it- thanks!
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Its been almost a year since I've had ONJ. I'm hoping the dead bone works its way out soon and I'll be done dealing with it.
Wandering, How are you doing? I know you've been dealing with ONJ for awhile now. Did you start out with one spot and it spread of kept coming back?
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I think my post disappeared. Sorry if this shows up twice.
To those of you with ONJ, how was it discovered? Jaw pain? Mouth sores? Something else?
Thanks!
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My ONJ showed up about a year ago. I had jaw pain, went to a dentist, he took xrays and told me that I needed to see an oral surgeon. He diagnosed the ONJ. I had extreme jaw pain. I could only open my mouth about an inch at first. The dead bone has gradually gotten worse which is why the oral surgeon wants to put in a titanium plate. The plate will not cure anything but hopefully keep my jaw from breaking, which would be really bad. I am currently on chemo to attack the MBC. Since I started chemo about a month and a half ago my tumor markers have started to come down. I cannot do anything about my jaw until the cancer is under control. I am hopeful something will happen (pills?) so I don't need to go through the surgery on my jaw, which everyone agrees will not be pleasant. I am 75 years of ago so I hope I can outlive the cancer and/or the ONJ. Who knows. My jaw is not currently very painful and I can live with it for the time being.
Cure-ious: thanks for looking into the trials for the pills. I am very interested to learn what you can find out, especially with your research skills.
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Wandering, YIKES! That sounds really scary. If I start having jaw pain, I'll not wait until it gets really bad. Thanks for letting me know. I hope you can get it "fixed" or at least stabilized.
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Mine started with an infected tooth that needed to be extracted. The gum area where the tooth was would not heal and bone could be seen so the oral surgeon ground down the bone until it was smooth and then cut and pulled gum tissue over it and stitched it in place. It is just not healing. I haven't had Xgeva for 3 or 4 mos. and now my MO said we will stop it completely. I see the oral surgeon next week after being on penicillin and prescription mouthwash. He told me about a patient that took over a year to get things on the right track. He called it ONJ but it really isn't my jaw. Right?
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Oh my, Lee! That sounds really uncomfortable! Good luck with getting that resolved! I've been getting my teeth cleaned every three months. Hopefully that will help me keep on top of any dental issues. My husband can go in every five years for cleaning. The dentist is always impressed at how clean his teeth are. Some things are just not fair! haha
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RK2020- How did your PET turn out?
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Pfizer's breast cancer drug Ibrance fails late-stage study
(Reuters) - Pfizer Inc said on Friday its cancer drug Ibrance did not meet the main goal in a late-stage trial in patients with a type of breast cancer, the latest setback in the company's attempt to expand the use of the drug to treat early stages of the disease.
The latest development comes after an independent data monitoring committee said in May a similar trial comparing Ibrance plus an endocrine therapy to a standalone endocrine therapy to treat early-stage breast cancer was unlikely to meet the main goal.
Ibrance is already approved in the United States to treat certain adult patients with advanced breast cancer which has spread to other parts of the body. The drug has not yet been approved for treating early stages of the disease.
This puts the drug at a relative disadvantage to rival Eli Lilly and Co, which in June posted data showing that its drug Verzenio, met the trial goal of reducing the risk of early-stage breast cancer from recurring.
"Today's data leaves Lilly's Verzenio as the clear winner in the adjuvant space for now, giving Verzenio a blockbuster opportunity in a potential early breast cancer indication," Cantor Fitzgerald analyst Louise Chen said.
In the late-stage trial, Ibrance failed to meet the main goal of increasing the amount of time patients survived without their cancer returning.
Lilly's shares were up 1% at $155.10 in pre-market trading, while Pfizer's stock was flat at $36.90.
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Thanks for posting, Jack5ie --
Gotta love big Pharma!
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BevJen...this makes you wonder if Verzenio is also better for patients that are Stage 4 over Ibrance.
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Jack5ie,
That is exactly what I was thinking. Maybe Ibrance isn't the dream drug that everyone thought.
I believe that Verzenio has been validated as a stand-alone drug as well. And it's a newer generation than Ibrance.
Very interesting.
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That sounds hopeful re Verzenio....I have a bad feeling re scan results as some of my initial MBC symptoms have reappeared in the last few days (pain and pressure in my back, upper quadrant, which signposted the pleural effusion that identified my lung mets), so I get the feeling I might be nearing the end of Ibrance. Might just be stress though...or gas!
We’ll see.....
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Jack5ie, It's just they were trying to show that adding Ibrance would reduce the number of recurrences in early stage patients- it didn't but its still a bit early of a time frame and some MOs were saying at ASCO 2020 that they think the trial might still succeed eventually, it takes a long time for mets to show up in a high number of patients. But its no surprise that Verzenio already showed success, because it is known to be 14x stronger than Ibrance as an inhibitor of CDK4,6 and also has a big of a broader range (hits other kinases), which is why you see the diarrhea problem more significant with Verzenio.
As a stronger drug it makes sense to move from Ibrance to Verzenio upon progression (esp if combining it with a Femara-Faslodex switch), but alternately you could consider the CDK2/4/6 inhibitor that Dee is taking, which is at least ten times stronger of a CDK4,6 inhibitor than Verzenio (100x stronger than Ibrance), plus it apparently does not come with the low neutrophil problem. Now that they optimized the CDK4,6 inhibitor part, the question becomes what are the side effects of the CDK2 inhibitor in that combo
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Hi Wandering,
Well, you know 75 is not really considered old age nowadays, so you gotta keep working at all this stuff, sorry about that!!
These medicines they are using for medication-induced ONJ, I did just a limited survey. They look good, one is an anti-TNFalpha and inhibits inflammation and the other is a vitamin E derivative, together they seem to really help. But I didn't really see them being tested on their own as an alternative to surgery? rather, as an add-on to current standard of care and also being used prophylactically so you would take them when getting invasive dental implant or other work that grinds on bone, to prevent from getting a problem with ONJ, that seems to work well.
With Xgeva, do we only have to worry about a problem if getting dental work? Because I seem to recall someone who had bone fragments just dig their way out through the roof of her mouth and it wasn't secondary to having any dental work done. was that the case? Because having taken the drug for a long time without not knowing how long one is "safe"? or if risks go up with time or not, is confounding. But reassuring to see there are these meds and different "grades" of ONJ, so to that we should be alert to developing any bone problems in the mouth. Does it always come with pain or is it possible that bone chips just appear one day out of nowhere, and maybe without having had dental work done?
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JACK5IE - thanks for the Ibrance article.
Cure-ious thanks for all of your insightful evaluations, never stop.
More generally this sad news came out lately -
Lucille Ball and Desi Arnaz's only great-granddaughter Desiree Anzalone has died at the age of 31.
Anzalone passed on September 27, in her home state of Connecticut, after a six-year battle with breast cancer -
Unbelievably tragic.
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Cureious - I seem to recall in the last 9 months or so there was a study about moving to 3 monthly Xgeva as standard of care in returning the same benefits vs cost and lowered risk. Frisky mentioned MSK were taking that approach and she was ok with it. My (soon to be new) MO seems to be somewhat tied into what is going on at MSK and proposed moving to 3 monthly in the new year (which I would be happy with). Am I just imagining this or was there actually a study done?
Karen - hopefully it is just from the power of suggestion and the mind and not progression!
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Cureious, I did not have any dental work done that would have caused ONJ and still got it. My oral surgeon said mine was spontaneous and thought it was caused from my tongue rubbing against my gums and wearing that area of gum down over time. He didn't think xgeva caused the problem but instead it was the bisphosphonates I took years ago.
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Simone, that's what I thought could happen- did it hurt or did he find it by inspecting your mouth? And then how do they fix that, when its gum loss and/or the bone has chipped off of somewhere.
Sondra, After two years of monthly Xgeva, I asked my MO to move to every three months, based on Jensgotthis saying that is what her docs at UCLA were doing because women were now staying on these drugs so long they were seeing a lot more ONJ..
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