Evaluation of the relationship between toxicity of cyclin-dependent kinase 4/6 inhibitors and body surface area

Dişli, Şafak Yildirim; Fidan, Evren

doi:10.1590/1806-9282.20230680

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Revista da Associação Médica Brasileira

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Original Article • Rev. Assoc. Med. Bras. 69 (12) • 2023 • https://doi.org/10.1590/1806-9282.20230680 copy

Evaluation of the relationship between toxicity of cyclin-dependent kinase 4/6 inhibitors and body surface area

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE:

This study aimed to evaluate the relationship between the toxicity of cyclin-dependent kinase 4/6 inhibitors and body mass index and body surface area.

METHODS:

A total of 83 patients were included in the study. Patients were divided into 4 groups as 18–24.9, 25–29.9, 30–39.9, and >40 kg/m² according to body mass index and into two groups as below and above 1.77 according to body surface area. The relationship between body mass index and body surface area and side effects was evaluated.

RESULTS:

No statistically significant difference was found between body mass index groups and side effects. Grade 3 neutropenia was more common in patients on palbociclib with a body surface area≤1.77. In our study, it was revealed that less hematological side effects can be encountered when body surface area is taken into account.

KEYWORDS:
Breast cancer; Drug toxicity; Body measures; Toxicity

		n	%
Body mass index, n (%)
	18–24.9	19	22.9
	25–29.9	26	31.3
	30–39.9	32	38.6
	40–60	6	7.2
Body surface area, n (%)
	1.77 or less	43	51.8
	1.77 over	40	48.2
Medicines, n (%)
	Ribociclib	62	74.7
	Palbociclib	21	25.3
Previous endocrinology treatment, n (%)
	Exist	45	54.2
	None	38	45.8
Neoadjuvant or adjuvant treatment, n (%)
	Exist	32	38.6
	None	51	61.4
Mortality, n (%)
	Right	73	88.0
	Ex	10	12.0
Progression, n (%)
	None	62	75.6
	Exist	20	24.4
		Mean±SD	Median (IQR)
	Age	51.29±12.65	51.00 (19.00)
	Body surface area	1.77±0.18	1.77 (0.29)
	Follow-up time	67.58±61.44	45.46 (79.73)

		Body surface area		p
		≤1.77	>1.77	p
Neutropenia, n (%)
	None	14 (32.6)	13 (32.5)	0.995^a a Pearson's chi-square test;
	Exist	29 (67.4)	27 (67.5)	0.995^a a Pearson's chi-square test;
GR1 neutropenia, n (%)
	None	38 (88.4)	27 (67.5)	0.021 ^a a Pearson's chi-square test;
	Exist	5 (11.6)	13 (32.5)	0.021 ^a a Pearson's chi-square test;
GR2 neutropenia, n (%)
	None	43 (100)	40 (100)	–
	Exist	–	–	–
GR3 neutropenia, n (%)
	None	22 (51.2)	26 (65)	0.202^a a Pearson's chi-square test;
	Exist	21 (48.8)	14 (35)	0.202^a a Pearson's chi-square test;
GR4 neutropenia, n (%)
	None	40 (93)	40 (100)	0.242^b b Fisher's exact test;
	Exist	3 (7)	0 (0)	0.242^b b Fisher's exact test;
LFT, n (%)
	None	35 (81.4)	37 (92.5)	0.136^a a Pearson's chi-square test;
	Exist	8 (18.6)	3 (7.5)	0.136^a a Pearson's chi-square test;
GR1 LFT, n (%)
	None	42 (97.7)	39 (97.5)	1.000^b b Fisher's exact test;
	Exist	1 (2.3)	1 (2.5)	1.000^b b Fisher's exact test;
GR2 LFT, n (%)
	None	41 (95.3)	40 (100)	0.495^b b Fisher's exact test;
	Exist	2 (4.7)	0 (0)	0.495^b b Fisher's exact test;
GR3 LFT, n (%)
	None	39 (90.7)	39 (97.5)	0.361^b b Fisher's exact test;
	Exist	4 (9.3)	1 (2.5)	0.361^b b Fisher's exact test;
GR4 LFT, n (%)
	None	42 (97.7)	39 (97.5)	1.000^b b Fisher's exact test;
	Exist	1 (2.3)	1 (2.5)	1.000^b b Fisher's exact test;
GFR decrease, n (%)
	None	39 (90.7)	37 (92.5)	1.000^b b Fisher's exact test;
	Exist	4 (9.3)	3 (7.5)	1.000^b b Fisher's exact test;
Soft tissue infection, n (%)
	None	43 (100)	36 (90)	0.050^b b Fisher's exact test;
	Exist	0 (0)	4 (10)	0.050^b b Fisher's exact test;
Other, n (%)
	None	40 (93)	35 (87.5)	0.473^b b Fisher's exact test;
	Exist	3 (7)	5 (12.5)	0.473^b b Fisher's exact test;

Palbociclib		Body surface area		p
Palbociclib		≤1.77	>1.77	p
Neutropenia, n (%)
	None	2 (18.2)	4 (40)	0.361^b b Fisher's exact test;
	Exist	9 (81.8)	6 (60)	0.361^b b Fisher's exact test;
GR1 neutropenia, n (%)
	None	11 (100)	7 (70)	0.090^b b Fisher's exact test;
	Exist	0 (0)	3 (30)	0.090^b b Fisher's exact test;
GR2 neutropenia, n (%)
	None	11 (100)	10 (100)	–
	Exist	–	–	–
GR3 neutropenia, n (%)
	None	2 (18.2)	7 (70)	0.030 ^b b Fisher's exact test;
	Exist	9 (81.8)	3 (30)	0.030 ^b b Fisher's exact test;
GR4 neutropenia, n (%)
	None	11 (100)	10 (100)	–
	Exist	–	–	–
LFT, n (%)
	None	10 (90.9)	9 (90)	1.000^b b Fisher's exact test;
	Exist	1 (9.1)	1 (10)	1.000^b b Fisher's exact test;
GR1 LFT, n (%)
	None	11 (100)	9 (90)	0.476^b b Fisher's exact test;
	Exist	0 (0)	1 (10)	0.476^b b Fisher's exact test;
GR2 LFT, n (%)
	None	10 (90.9)	10 (100)	1.000^b b Fisher's exact test;
	Exist	1 (9.1)	0 (0)	1.000^b b Fisher's exact test;
GR3 LFT, n (%)
	None	11 (100)	10 (100)	–
	Exist	–	–	–
GR4 LFT, n (%)
	None	11 (100)	10 (100)	–
	Exist	–	–	–
GFR decrease, n (%)
	None	9 (81.8)	9 (90)	1.000^b b Fisher's exact test;
	Exist	2 (18.2)	1 (10)	1.000^b b Fisher's exact test;
Soft tissue infection, n (%)
	None	11 (100)	7 (70)	0.090^b b Fisher's exact test;
	Exist	0 (0)	3 (30)	0.090^b b Fisher's exact test;
Other, n (%)
	None	11 (100)	8 (80)	0.214^b b Fisher's exact test;
	Exist	0 (0)	2 (20)	0.214^b b Fisher's exact test;

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