Palbociclib

Uses	HR-positive, HER2-negative advanced or metastatic breast cancer
Therapy	Anti-Neoplastic
Side Effects	Low white cell counts, infections, tiredness, nausea, mouth sores

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Molecule Description

Palbociclib is a targeted cancer medicine known as a CDK4/6 inhibitor. It is used together with hormone therapy to treat hormone receptor (HR) positive, HER2-negative advanced or metastatic breast cancer. It slows the growth of cancer cells by blocking proteins called CDK4 and CDK6, which cells need in order to divide. It is taken by mouth with or without food. The capsule or tablet is swallowed whole and should not be chewed, crushed or opened, and damaged ones should be discarded. Common effects include low white blood cell counts, infections, tiredness, nausea, mouth sores, anaemia, hair thinning, diarrhoea, low platelet counts, rash, vomiting, reduced appetite and weakness. A fever during treatment, especially with a very low white cell count, can signal a serious infection and needs immediate medical attention. Your doctor will check your blood counts regularly and may monitor liver and kidney function. Tell your doctor about all medicines, vitamins, supplements and herbal products you take because some can change Palbociclib levels. Palbociclib may harm an unborn baby and is not recommended during breastfeeding.

Uses

Palbociclib is used in combination with hormonal therapy to treat hormone receptor positive, HER2-negative advanced or metastatic breast cancer.

Contraindications

When should one not use Palbociclib

If you are allergic to Palbociclib.

Side effects

Common side effects of this drug are:

Low white blood cell counts (neutropenia and leukopenia)
Infections
Anaemia
Low platelet counts
Tiredness (fatigue) and weakness
Fever
Mouth sores (stomatitis)
Nausea
Diarrhoea
Reduced appetite
Rash
Hair loss

Precautions and Warnings

Pregnancy

Palbociclib may harm an unborn baby and is not recommended during pregnancy. Women who could become pregnant should use effective contraception during treatment and for the period their doctor advises after the last dose.

Breast Feeding

No. It is not known whether Palbociclib passes into human breast milk. Do not breastfeed during treatment or for the period your doctor advises after the last dose due to the risk of the harm to the nursing infant.

Driving

Palbociclib very commonly causes tiredness and weakness, and some people may develop blurred vision. Avoid driving or using machinery if you feel affected, and discuss any concerns with your doctor.

Alcohol

It is best to avoid alcohol use. Discuss alcohol consumption with your doctor, who can advise based on your overall condition and treatment plan.

Other General Warnings

Talk to your doctor if

You develop fever, chills, dizziness, shortness of breath, weakness, or unusual bruising or bleeding, as these may be signs of low blood cell counts or infection and require prompt medical attention.
You develop a new or worsening cough, shortness of breath, or other breathing problems, as these may be signs of inflammation or other problems affecting the lungs.
You have severe kidney problems, as your doctor may need to review your health before deciding your treatment.
You are taking or are about to start any medicine that strongly affects the CYP3A enzyme, as it may interact with palbociclib.
There is any possibility that you are pregnant or could become pregnant, as palbociclib can harm an unborn baby.
You are breastfeeding, as breastfeeding is not recommended during treatment with palbociclib and for 3 weeks after the last dose.
You are due for blood tests, as your blood cell counts need to be checked regularly during treatment.

Mode of Action

How Does It Work?

Palbociclib blocks two proteins, CDK4 and CDK6, that help cancer cells move through the cell-division cycle. By blocking them, it slows or stops breast cancer cells from dividing, which helps control tumour growth. Used together with hormone therapy such as an aromatase inhibitor, it adds to the effect of the hormone medicine on hormone-sensitive breast cancer cells.

Interactions

Interactions with other medicines

Tell your doctor about all medicines, vitamins, supplements and herbal products you take or plan to take.
Avoid St John’s wort while taking palbociclib, as it can reduce the level of palbociclib in your body and may reduce its effect.
Avoid medicines that strongly increase or decrease the activity of the CYP3A enzyme, as they can increase or decrease the level of palbociclib in your body.
Tell your doctor before starting or stopping any medicine that may interact with palbociclib. Your doctor may adjust your palbociclib dose or recommend an alternative medicine.

Interactions with food items

You can take Palbociclib with or without food.

Dosage

Overdose

There is no known antidote for Palbociclib overdose. If more than the prescribed amount is taken, contact your doctor or go to the nearest hospital immediately. Treatment of an overdose consists of general supportive medical care and monitoring of symptoms.

Missed a Dose

If you miss a dose, or if you vomit after taking a dose, do not take an extra dose to make up for it. Take your next dose at the usual scheduled time. If unsure about what to do you can contact your doctor.

Frequently Asked Questions (FAQs)

It is designed to work alongside hormone treatment. Your doctor will decide what works best for your condition. The hormone medicine helps to reduces the oestrogen signal driving the cancer, while Palbociclib blocks the proteins the cells need to divide. Together they control hormone-sensitive breast cancer better than either alone.

The most common effect is a fall in white blood cells, which raises the risk of infection. Regular blood counts let your doctor pick this up early and pause or adjust treatment if needed.

Grapefruit blocks an enzyme that breaks this medicine down, which can raise its level in the blood and increase side effects. Avoid grapefruit and grapefruit juice during treatment.

Contact your doctor straight away. A fever, particularly alongside a very low white cell count, can indicate a serious infection that needs urgent treatment.