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Objective To evaluate progression free survival (PFS) in patients with advanced or metastatic, hormone receptor positive (HR+), HER2-negative (HER2-) breast cancer treated with palbociclib in combination with fulvestrant as second or later lines of treatment. Method: An observational, retrospective study with cohorts in 11 sites in Colombia, extracted from the medical records of women who began treatment between February 2018 and August 2019. Index date was first prescription, and patients were followed until they experienced disease progression, death, treatment discontinuation, were lost to follow-up, or until 12 months of follow-up, whichever occurred first. Kaplan Meier were used to estimate PFS. Results Sixty-nine patients who received at least one dose of the drugs were included in the analysis. Median follow-up was 10.81 ± 3.18 months, mean age was 61.2 ± 11.14 years and 96.3% were postmenopausal. At the time of starting treatment, 52 were in stage IV, with 59 with > 2 sites of metastasis. All patients started on palbociclib 125 mg. 23 reported discontinuation, 10 of them permanently but none due to neutropenia. Clinical benefit rate was 69.35%, and median PFS was not achieved at 12 months. One death was reported due to disease progression. Conclusion Effectiveness of Palbociclib for patients with HR+/HER2- advanced or metastatic breast cancer treated with palbociclib in combination with fulvestrant as second or later lines of treatment in Colombia is consistent with the efficacy observed in clinical trials while maintaining a good safety profile. Implications for practice: Real-world data from Colombia for the first time indicates the combination of palbociclib + fulvestrant is associated with high levels of effectiveness in women with HR+/HER2- advanced or metastatic breast cancer, even in third or later lines of treatment. Although neutropenia was frequent and, in some cases, clinically significant, no patients required permanent treatment discontinuation due to this event. All of the adverse effects resolved without sequelae, and no deaths due to this cause were seen. This confirms an adequate safety profile for the drug combination.

This study examines the asymmetries among the different interests of officials and medical doctors who worked for the Rockefeller Foundation and their Colombian counterparts in the development and consolidation of the concept of "jungle yellow fever," as distinguished from the known urban form of yellow fever. We explore the research responses to a variety of disease outbreaks in Colombia in the context of the Rockefeller campaigns against yellow fever, from the time of Roberto Franco's initial description of "yellow fever of the forests" in 1907 until the consolidation of the concept of "jungle yellow fever" by Fred Soper in 1938.

Este estudio examina las asimetrías entre los diferentes intereses de los funcionarios y médicos que trabajaron para la Fundación Rockefeller y sus contrapartes colombianas en el desarrollo y consolidación del concepto de 'fiebre amarilla de la selva', a diferencia de la conocida forma urbana de fiebre amarilla. Exploramos las respuestas de investigación a una variedad de brotes de enfermedades en Colombia en el contexto de las campañas de Rockefeller contra la fiebre amarilla, desde la descripción inicial de Roberto Franco de la 'fiebre amarilla de los bosques' en 1907 hasta la consolidación del concepto. de 'fiebre amarilla de la jungla' de Fred Soper en 1938. This study examines the asymmetries among the different interests of officials and medical doctors who worked for the Rockefeller Foundation and their Colombian counterparts in the development and consolidation of the concept of “jungle yellow fever,” as distinguished from the known urban form ofyellow fever. We explore the research responses to a variety of disease outbreaks in Colombia in the context of the Rockefeller campaigns against yellow fever, from the time of Roberto Franco’s initial description of “yellow fever of the forests” in 1907 until the consolidation of the concept of “jungle yellow fever” by Fred Soper in 1938. Cette étude examine las divergencias de interes parmi les fonction-naires et les meddecins qui ont travaillé pour la Fondation Rockefeller et sa filiale colombienne dans le développement et la consolidation du concept de «la fièvre jaune selvatique», qui diffère de la forme connue de fièvre jaune urbaine. Nous explorons les réponses de recherche à une variété d'irruptions de maladie en Colombie dans le contextte des campagnes de la Fondation Rockefeller con-tre la fìèvre jaune depuis la description initle de la «fièvre jaune des forêts» de Roberto Franco en 1907 jusqu ' à la consolidación del concepto de fièvre jaune sel-vatique por Fred Soper en 1938.