Does the Rechallenge with Another CDK 4/6 Inhibitor in Breast Cancer Work? A Case Report and Literature Review
Cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors and endocrine therapy are the gold standards for systemic therapy for patients with hormone-positive (HR+)/human epidermal growth factor receptor-2-negative (HER2-) metastatic breast cancer. Following progression, no prospective randomized data exi...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/4/696 |
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| author | Ioana-Miruna Stanciu Cristina Florina Pirlog Andrei-Wilhelm Anghel Andreea Ioana Parosanu Cristina Mihaela Olaru Cristina Orlov-Slavu Ion Cristian Iaciu Ana Maria Popa Radu Constantin Vrabie Cornelia Nitipir |
| author_facet | Ioana-Miruna Stanciu Cristina Florina Pirlog Andrei-Wilhelm Anghel Andreea Ioana Parosanu Cristina Mihaela Olaru Cristina Orlov-Slavu Ion Cristian Iaciu Ana Maria Popa Radu Constantin Vrabie Cornelia Nitipir |
| author_sort | Ioana-Miruna Stanciu |
| collection | DOAJ |
| description | Cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors and endocrine therapy are the gold standards for systemic therapy for patients with hormone-positive (HR+)/human epidermal growth factor receptor-2-negative (HER2-) metastatic breast cancer. Following progression, no prospective randomized data exist to help guide second-line treatment. Moreover, there is a scarcity of data on rechallenge treatment strategies with another CDK4/6 inhibitor after prior limiting toxicity. We report a real-world experience of rechallenging with abemaciclib after the prior reaction of grade 4 liver toxicity to ribociclib, with high transaminases values of more than 27 times the upper limit of normal (ULN) and unexpected grade 3 neutropenia and diarrhea after a few months of abemaciclib. After two years of treatment, the patient had stable oncological disease, with normal complete blood count, hepatic enzymes, and a very good performance status. We believe that our clinical case, along with others gathered from all around the world, will help with the consolidation of an unmet clinical need to readjust the treatment after experiencing toxicity to CDK4/6 inhibitors. |
| first_indexed | 2024-03-11T04:46:17Z |
| format | Article |
| id | doaj.art-3937aff8b0fd4bc7a9b4c3be4d446f1b |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T04:46:17Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-3937aff8b0fd4bc7a9b4c3be4d446f1b2023-11-17T20:20:40ZengMDPI AGMedicina1010-660X1648-91442023-04-0159469610.3390/medicina59040696Does the Rechallenge with Another CDK 4/6 Inhibitor in Breast Cancer Work? A Case Report and Literature ReviewIoana-Miruna Stanciu0Cristina Florina Pirlog1Andrei-Wilhelm Anghel2Andreea Ioana Parosanu3Cristina Mihaela Olaru4Cristina Orlov-Slavu5Ion Cristian Iaciu6Ana Maria Popa7Radu Constantin Vrabie8Cornelia Nitipir9Department of Oncology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Oncology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Oncology, Elias University Emergency Hospital, 011461 Bucharest, RomaniaDepartment of Oncology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Oncology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Oncology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Oncology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Oncology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Oncology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Oncology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaCyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors and endocrine therapy are the gold standards for systemic therapy for patients with hormone-positive (HR+)/human epidermal growth factor receptor-2-negative (HER2-) metastatic breast cancer. Following progression, no prospective randomized data exist to help guide second-line treatment. Moreover, there is a scarcity of data on rechallenge treatment strategies with another CDK4/6 inhibitor after prior limiting toxicity. We report a real-world experience of rechallenging with abemaciclib after the prior reaction of grade 4 liver toxicity to ribociclib, with high transaminases values of more than 27 times the upper limit of normal (ULN) and unexpected grade 3 neutropenia and diarrhea after a few months of abemaciclib. After two years of treatment, the patient had stable oncological disease, with normal complete blood count, hepatic enzymes, and a very good performance status. We believe that our clinical case, along with others gathered from all around the world, will help with the consolidation of an unmet clinical need to readjust the treatment after experiencing toxicity to CDK4/6 inhibitors.https://www.mdpi.com/1648-9144/59/4/696CDK4/6 inhibitorsCDK4/6 rechallengeCDK4/6 toxicityribociclibabemaciclib |
| spellingShingle | Ioana-Miruna Stanciu Cristina Florina Pirlog Andrei-Wilhelm Anghel Andreea Ioana Parosanu Cristina Mihaela Olaru Cristina Orlov-Slavu Ion Cristian Iaciu Ana Maria Popa Radu Constantin Vrabie Cornelia Nitipir Does the Rechallenge with Another CDK 4/6 Inhibitor in Breast Cancer Work? A Case Report and Literature Review Medicina CDK4/6 inhibitors CDK4/6 rechallenge CDK4/6 toxicity ribociclib abemaciclib |
| title | Does the Rechallenge with Another CDK 4/6 Inhibitor in Breast Cancer Work? A Case Report and Literature Review |
| title_full | Does the Rechallenge with Another CDK 4/6 Inhibitor in Breast Cancer Work? A Case Report and Literature Review |
| title_fullStr | Does the Rechallenge with Another CDK 4/6 Inhibitor in Breast Cancer Work? A Case Report and Literature Review |
| title_full_unstemmed | Does the Rechallenge with Another CDK 4/6 Inhibitor in Breast Cancer Work? A Case Report and Literature Review |
| title_short | Does the Rechallenge with Another CDK 4/6 Inhibitor in Breast Cancer Work? A Case Report and Literature Review |
| title_sort | does the rechallenge with another cdk 4 6 inhibitor in breast cancer work a case report and literature review |
| topic | CDK4/6 inhibitors CDK4/6 rechallenge CDK4/6 toxicity ribociclib abemaciclib |
| url | https://www.mdpi.com/1648-9144/59/4/696 |
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