Cover art for podcast Blood & Cancer

Blood & Cancer

70 EpisodesProduced by MDedge Hematology OncologyWebsite

Interview-style hematology/oncology podcast from MDedge Hematology-Oncology. The show is hosted by Dr. David Henry with Pearls from Dr. Ilana Yurkiewicz for clinical hematology and oncology health care professionals. The information in this podcast is provided for informational and educational purpo… read more

30:03

Breast Cancer, CDK4/6 Inhibitors

We'd love to hear from you with ideas, suggestions, feedback, and questions for Dr. Henry or Dr. Yurkeiwicz at podcasts@mdedge.com and you can follow MDedge Hematology/Oncology at @MDedgeHemOnc.

 

Blood & Cancer episode 10:
CDK4/6 inhibitors in breast cancer

Richard Finn, MD, of the Geffen School of Medicine at UCLA joins guest host Jame Abraham, MD, of the Cleveland Clinic to discuss CDK4/6 inhibitors in the treatment of breast cancer, from the first pivotal studies to efficacy and patient selection.

Later, Ilana Yurkiewicz, MD, talks about why it’s problematic to tell patients there is no more treatment in this week’s Clinical Correlation. Dr. Yurkiewicz is a fellow in hematology and oncology at Stanford University and is also a columnist for Hematology News.

 

Show notes

By Emily Bryer, DO, Resident in the department of internal medicine, University of Pennsylvania.

  • Cyclin dependent kinase 4 and 6 (CDK4/6) control phosphorylation of the retinoblastoma gene product in the G1 to S transition of the cell cycle.
  • Luminal ER-positive HER2-negative breast cancers are most sensitive to inhibition with a CDK4/6 inhibitor and act synergistically with tamoxifen.
  • PALOMA 1 trial studied CDK4/6 Inhibitors in ER-positive breast cancer.
    • Letrozole alone (10-month PFS) versus letrozole plus palbociclib (greater than 20-month PFS)
    • Toxicity = grade 3 (ANC 500-1000) and grade 4 neutropenia (ANC less than 500)
    • Low incidence of neutropenic fever

  • Palbociclib and chemotherapy have distinct effects on the bone marrow.
    • Palbociclib is cytostatic (also, toxicity is predictable and not cumulative)
    • Chemotherapy is cytocidal

  • Although efficacy is similar between CDK4/6 inhibitors (PFS hazard ratio +/-0.5), side effects vary.
    • Ribociclib and palbociclib have a higher incidence of neutropenia
    • Ribociclib affects QTC interval and liver enzymes
    • Abemaciclib is associated with diarrhea and venous thromboembolism

  • Ongoing studies are exploring 1) CDK4/6 inhibitor plus endocrine therapy versus endocrine therapy alone and 2) CDK4/6 inhibitors in the adjuvant setting.
  • The population to most benefit from CDK4/6 inhibitors may include the patients who are high-risk for relapse following endocrine therapy alone (previously those who would also receive chemotherapy).

Additional reading

  1. N Engl J Med 2018; 379:1926-36.
  2. Breast Cancer. 2018 Jul;25(4):402-6.
Educational emoji reaction

Educational

Interesting emoji reaction

Interesting

Funny emoji reaction

Funny

Agree emoji reaction

Agree

Love emoji reaction

Love

Wow emoji reaction

Wow

Are you the creator of this podcast?

Verify your account

and pick the featured episodes for your show.

Listen to Blood & Cancer

RadioPublic

A free podcast app for iPhone and Android

  • User-created playlists and collections
  • Download episodes while on WiFi to listen without using mobile data
  • Stream podcast episodes without waiting for a download
  • Queue episodes to create a personal continuous playlist
RadioPublic on iOS and Android
Or by RSS
RSS feed
http://jcsopodcast.mdedge.libsynpro.com/radiopublic

Connect with listeners

Podcasters use the RadioPublic listener relationship platform to build lasting connections with fans

Yes, let's begin connecting
Browser window

Find new listeners

  • A dedicated website for your podcast
  • Web embed players designed to convert visitors to listeners in the RadioPublic apps for iPhone and Android
Clicking mouse cursor

Understand your audience

  • Capture listener activity with affinity scores
  • Measure your promotional campaigns and integrate with Google and Facebook analytics
Graph of increasing value

Engage your fanbase

  • Deliver timely Calls To Action, including email acquistion for your mailing list
  • Share exactly the right moment in an episode via text, email, and social media
Icon of cellphone with money

Make money

  • Tip and transfer funds directly to podcastsers
  • Earn money for qualified plays in the RadioPublic apps with Paid Listens