Ibrance emerges as a new drug partner for metastatic breast

[Interview] Joo-Hyeok Son, Professor, Department of Oncology, Yonsei Cancer Hospital

Prescribing without hesitation even for 80-year-old patients

Active research on new drugs such as oral SERD, selected Ibrance for combination drugs

Professor Joo-Hyeok Son, Department of Oncology, Yonsei Cancer Hospital

CDK4/6 inhibitor Ibrance is emerging as a combination partner for metastatic breast cancer drug developers based on its long-accumulated treatment experience.

 

Even if the dose is increased, there is little concern about side effects, so it is expected that it will be used as a variety of combination drugs.

 

Ibrance is the first CDK4/6 inhibitor developed by Pfizer and was launched in Korea in the fourth quarter of 2016.

 

It provided a new treatment option for patients with HR+/HER2- metastatic breast cancer who had to use anti-hormonal drugs such as aromatase inhibitors or chemotherapy if not managed with these drugs.

 

Ibrance, which held the top spot in the CDK4/6 market for five years, faced a decline for the first time last year.

 

According to IQVIA, a pharmaceutical market research institute, Ibrance sales decreased 14% from 65.6 billion won in 2021 to 56.2 billion won last year.

 

The rapid growth of generics has affected Ibrance's sales.

 

Generics such as Verzenio and Kisqali are breaking down Ibrance's dominance through more sophisticated clinical trials and new field development.

 

In particular, with generic drugs expanding their scope to early breast cancer, prospects are raised that Ibrance's position, which is limited to metastatic breast cancer, will narrow.

 

In this situation, Iran is trying to turn around by emerging as a new drug combination partner for metastatic breast cancer.

 

In an interview with Daily Pharm, Professor Sohn Joo-hyeok of the Department of Oncology at Yonsei Cancer Hospital said, "To use an oral SERD instead of an aromatase inhibitor, it must be used in combination with CDK4/6, but Irance is widely adopted as a combination drug." It means being recognized." Recently, oral SERD development is in full swing as a CDK4/6 inhibitor combination therapy for breast cancer.

 

Many global pharmaceutical companies such as Pfizer, AstraZeneca, and Menarini jumped into the market.

 

Big pharma is in the midst of studying combination therapy with CDK4/6 inhibitors as well as oral SERD monotherapy, and most of them chose Ibrance as the combination drug.

 

Professor Sohn cited safety as the reason why Ibrance received much love calls as a combination drug.

 

Professor Sohn said, "Ibrance's strength is that it is stable as it has accumulated the longest treatment experience among CDK4/6 inhibitors." It's less, so I'll consider it first," he explained.

 

This evaluation was proven with real-world data.

 

The Ibrance P-REALITY X study conducted by Pfizer is a large-scale real-world study that retrospectively analyzed the data of 2888 patients with HR+/HER2- metastatic breast cancer enrolled from February 2015 to March 2020.

 

Patients receiving Ibrance plus Letrozole combination therapy as a first-line treatment option were compared with patients on Letrozole monotherapy.

 

As a result of matching the baseline characteristics of the two groups similarly, the median overall survival (mOS) of the Ibrance group was 49.1 months, which was significantly prolonged compared to 43.2 months of the Letrozole single group, reducing the risk of death by 24%.

 

It is less toxic, so even elderly patients can use it without burden.

 

As a result of a sub-analysis examining Ibrance and Letrozole combination therapy in elderly patients aged 65 years or older, the median progression-free survival (mPFS) was 30.6 months, compared to 19.1 months in the control group.

 

Professor Sohn said, "Recently, I prescribed Ibrance to an 80-year-old elderly patient with an anti-hormone drug.

 

The treatment went well, and people around me said, 'How can you correct this when you are receiving chemotherapy at an advanced age?' I always worry about prescribing medications for cancer, but Ibrance greatly eases that burden."