Allen Wilbanks finds himself at SABCS 2023, where he engages in a discussion with Dr. Adam Brufsky, a medical doctor, professor of medicine, and associate chief division hematology, oncology, and co-director of the Comprehensive Breast Cancer Center at the University of Pittsburgh.
In the interview, Allen queries Dr. Brufsky about the real-world effectiveness of Palbociclib, or palbociclib, in combination with aromatase inhibitors for metastatic breast cancer patients with cardiovascular disease. Dr. Brufsky delves into the key findings of the study, highlighting the analysis of patients who were not part of clinical trials, and emphasizing the significance of real-world evidence.
The study, known as P RealityX, examined patients from the Flatiron database over an 8 to 10-year period. Dr. Brufsky describes the methodology, including the use of statistical techniques like inverse probability treatment weighting and propensity score matching to balance characteristics between patient groups. The primary findings indicate that Palbociclib in combination with aromatase inhibitors benefits patients with cardiovascular disease, showing improved overall survival and progression-free survival.
The discussion further explores how the study managed cardiovascular comorbidities during treatment, ensuring patients received necessary medications as prescribed by their cardiologists and primary physicians. Dr. Brufsky notes the absence of significant drug interactions and consistent safety.
Addressing the potential impact of specific cardiovascular conditions or risk factors on treatment effectiveness, Dr. Brufsky reveals that the benefits of Palbociclib remained consistent regardless of the number of cardiovascular comorbidities.
In terms of clinical management implications, Dr. Brufsky emphasizes the importance of real-world studies to complement randomized trials, offering insights into the use of drugs in patient populations excluded from traditional trials. He suggests that the study results provide comfort in using Palbociclib in patients with pre-existing cardiovascular conditions.
In conclusion, Dr. Brufsky recommends a cautious yet affirmative approach in treating metastatic breast cancer patients with cardiovascular morbidity, expressing confidence in the safety and effectiveness of Palbociclib based on the study’s findings. The interview concludes with gratitude from Allen Wilbanks for Dr. Brufsky’s valuable insights at SABCS 2023.