Treatment Name: Palbociclib (Ibrance®) + Fulvestrant (Faslodex®)
Palbociclib (Ibrance®) + Fulvestrant (Faslodex®) is a Chemotherapy Regimen for Breast Cancer - metastatic
How does palbociclib + fulvestrant work?
Palbociclib is designed to inhibit a specific protein that is responsible for turning off tumor suppressor genes and allowing the cancer cell to grow and divide. By inhibiting this protein, palbociclib causes the cell to stop actively dividing (growing).
Fulvestrant is designed to block estrogen receptors on the surface of breast cancer cells. In patients with Estrogen Receptor positive (ER+) disease, estrogen binds to these receptors and tells the breast cancer cells to grow and divide. Fulvestrant blocks this signal and helps stop the breast cancer cells from growing.
Goals of therapy:
Palbociclib + fulvestrant are taken together to slow the growth of breast cancer and prevent it from spreading further. This therapy is not usually given with the goal of cure.
- Palbociclib usual starting dose: 125 mg oral capsule by mouth Once Daily for 21 consecutive days, followed by no drug during a 7-day rest period
- Fulvestrant intramuscular (I.M.) injection every two weeks for three doses, then once monthly thereafter
Palbociclib is usually taken at home while fulvestrant is given in an outpatient infusion center or doctor’s office. Palbociclib + fulvestrant is taken until the regimen no longer works or until unacceptable side effects occur.
Click here for common starting doses of Ibrance + Faslodex.
In a multi-drug regimen, each medication has unique side effects. When these medicines are given together, drug-related side effects reported in clinical studies give the best estimate of what to expect. In clinical studies, the most commonly reported drug side effects with palbociclib + fulvestrant are shown here:
On average, 3% of patients discontinue palbociclib + fulvestrant due to unacceptable side effects.
How often is monitoring needed?
Labs (blood tests) may be checked before starting treatment, then every 2 weeks during the first two cycles, then monthly thereafter. Labs often include: complete blood count (CBC), comprehensive metabolic panel (CMP), plus any others your doctor may order.
How often is imaging needed?
Imaging may be checked before treatment and every two to six months during treatment. Imaging may include: bone scans, magnetic resonance imaging (MRI), and computerized tomography (CT) scans. DEXA (dual energy x-ray absorptiometry) scans may be performed to monitor your bone mineral density.
How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue palbociclib + fulvestrant as planned, or delay or switch therapy.
- Of the patients that experienced any hair loss, it was usually not obvious from a distance and could be seen only on close inspection. For a few patients, a different hair style may help cover up hair loss. A wig or hair piece to camouflage hair loss is almost never required for patients receiving this regimen
- Only a certain amount of fluid can be given by intramuscular (I.M.) injection at one time. Because of this, the total dose of fulvestrant must be given as two separate injections on the same day. Each injection will be given slowly over 1-2 minutes, one in each buttock
- A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
- Clinical trials may exist for breast cancer. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications
Patient Assistance & Co-payment Coverage
Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Palbociclib (Ibrance®) + Fulvestrant (Faslodex®), we have provided links that may help.
Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Palbociclib (Ibrance®) + Fulvestrant (Faslodex®). Depending upon your income, they may be able to help cover the cost of:
For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.
- If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.
Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Palbociclib (Ibrance®) + Fulvestrant (Faslodex®) and are the best source to help you understand drug cost.
- Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.
What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.
Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.
Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.
Learn more about pursuing emotional wellness while receiving treatment with Palbociclib (Ibrance®) + Fulvestrant (Faslodex®)