Vol. 5, Issue 2, Part A (2025)

Background: Breast cancer is the most common malignancy and the leading cause of cancer-related death among women in Iraq. A major challenge in its management is endocrine resistance, which refers to disease progression or recurrence during adjuvant endocrine therapy. Overcoming this resistance is essential to delay chemotherapy and improve patient outcomes and quality of life. Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors, particularly Palbociclib, have emerged as promising agents in this context due to their efficacy and manageable side effect profiles.
Objectives: To compare health-related quality of life (HRQoL) and side effects in metastatic breast cancer patients receiving Palbociclib plus endocrine therapy versus endocrine therapy alone.
Patients and Methods: This prospective study was conducted from November 1, 2022, to September 30, 2023, at the Oncology Teaching Hospital and Al-Amal National Hospital in Baghdad, Iraq. A total of 90 female patients with metastatic breast cancer were enrolled using convenience sampling and divided into two groups (2:1 ratio): Group 1 (n=60) received Palbociclib plus endocrine therapy, and Group 2 (n=30) received endocrine therapy alone. Data collection included demographics, clinical characteristics, ECOG performance status, and HRQoL assessed using the EORTC QLQ-C30 questionnaire. Non-parametric tests were applied; P < 0.05 was considered significant.
Results: Group 1 showed significant improvements in global QoL, emotional and social functioning, and pain, though with increased fatigue, appetite loss, and diarrhea. Group 2 experienced improved physical and social functioning, with worsening fatigue. Between-group comparisons favored Group 1 for emotional functioning, fatigue, and pain. Conclusion: Palbociclib combined with endocrine therapy provided superior improvements in QoL domains, indicating its advantage in managing metastatic breast cancer.