Vitiligo-Like Lesions in a Patient with Metastatic Breast Cancer Treated with Cyclin-Dependent Kinase (CDK) 4/6 Inhibitor: A Case Report and Literature Review

Baha’ Sharaf,1 Rama AlMasri,2 Nayef Abdel-Razeq,3 Osama Salama,1 Ibrahim Hamad,1 Mahmoud Abunasser,1 Hikmat Abdel-Razeq1,4 1Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan; 2Department of Internal Medicine, Istishari Hospital, Amman, Jordan; 3Department of Internal Medicin...

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Main Authors: Sharaf B, AlMasri R, Abdel-Razeq N, Salama O, Hamad I, Abunasser M, Abdel-Razeq H
Format: Article
Language:English
Published: Dove Medical Press 2022-01-01
Series:Clinical, Cosmetic and Investigational Dermatology
Subjects:
Online Access:https://www.dovepress.com/vitiligo-like-lesions-in-a-patient-with-metastatic-breast-cancer-treat-peer-reviewed-fulltext-article-CCID
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author Sharaf B
AlMasri R
Abdel-Razeq N
Salama O
Hamad I
Abunasser M
Abdel-Razeq H
author_facet Sharaf B
AlMasri R
Abdel-Razeq N
Salama O
Hamad I
Abunasser M
Abdel-Razeq H
author_sort Sharaf B
collection DOAJ
description Baha’ Sharaf,1 Rama AlMasri,2 Nayef Abdel-Razeq,3 Osama Salama,1 Ibrahim Hamad,1 Mahmoud Abunasser,1 Hikmat Abdel-Razeq1,4 1Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan; 2Department of Internal Medicine, Istishari Hospital, Amman, Jordan; 3Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA; 4School of Medicine, University of Jordan, Amman, JordanCorrespondence: Hikmat Abdel-RazeqDepartment of Internal Medicine, King Hussein Cancer Center, School of Medicine, University of Jordan, Queen Rania Al Abdullah Street, PO Box 1269, Amman 11941, JordanTel + 962-6 5300460, Ext: 1000Email habdelrazeq@khcc.joBackground: Cyclin-dependent kinase (CDK) 4/6 inhibitors have revolutionized the treatment landscape of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer, with an impressive efficacy and safety profile. Cytopenia is the main adverse event, which is both predictable and manageable. Here, we report a case of CDK4/6 inhibitor-induced vitiligo-like lesions. Vitiligo or vitiligo-like lesions are a rare adverse event; only a few cases are reported in the literature.Case Presentation: A 71-year-old female patient was diagnosed initially with early-stage right breast cancer (HR+/HER2−) and was treated with breast-conserving surgery followed by chemotherapy, radiotherapy, and hormonal therapy. A few years later, she developed metastatic disease to the hilar lymph nodes, and to multiple skeletal sites, including the left scapula, left shoulder, left iliac bone, and dorsal vertebrae, for which she was treated with ribociclib and letrozole. While on treatment, she developed hypopigmented lesions involving both hands, feet, and face, which were described as vitiligo-like lesions.Conclusion: CDK4/6 inhibitor-induced vitiligo is a rare and unpredictable adverse event. This case report highlights the rarity of this adverse event, the dilemma related to the optimal treatment, and decisions related to continuation, holding, or switching CDK4/6 inhibitors.Keywords: CDK4/6 inhibitors, ribociclib, vitiligo, vitiligo-like, breast cancer, skin adverse events
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spelling doaj.art-8ac650842992489d9e8281c8e23266712022-12-21T19:38:18ZengDove Medical PressClinical, Cosmetic and Investigational Dermatology1178-70152022-01-01Volume 1551072025Vitiligo-Like Lesions in a Patient with Metastatic Breast Cancer Treated with Cyclin-Dependent Kinase (CDK) 4/6 Inhibitor: A Case Report and Literature ReviewSharaf BAlMasri RAbdel-Razeq NSalama OHamad IAbunasser MAbdel-Razeq HBaha’ Sharaf,1 Rama AlMasri,2 Nayef Abdel-Razeq,3 Osama Salama,1 Ibrahim Hamad,1 Mahmoud Abunasser,1 Hikmat Abdel-Razeq1,4 1Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan; 2Department of Internal Medicine, Istishari Hospital, Amman, Jordan; 3Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA; 4School of Medicine, University of Jordan, Amman, JordanCorrespondence: Hikmat Abdel-RazeqDepartment of Internal Medicine, King Hussein Cancer Center, School of Medicine, University of Jordan, Queen Rania Al Abdullah Street, PO Box 1269, Amman 11941, JordanTel + 962-6 5300460, Ext: 1000Email habdelrazeq@khcc.joBackground: Cyclin-dependent kinase (CDK) 4/6 inhibitors have revolutionized the treatment landscape of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer, with an impressive efficacy and safety profile. Cytopenia is the main adverse event, which is both predictable and manageable. Here, we report a case of CDK4/6 inhibitor-induced vitiligo-like lesions. Vitiligo or vitiligo-like lesions are a rare adverse event; only a few cases are reported in the literature.Case Presentation: A 71-year-old female patient was diagnosed initially with early-stage right breast cancer (HR+/HER2−) and was treated with breast-conserving surgery followed by chemotherapy, radiotherapy, and hormonal therapy. A few years later, she developed metastatic disease to the hilar lymph nodes, and to multiple skeletal sites, including the left scapula, left shoulder, left iliac bone, and dorsal vertebrae, for which she was treated with ribociclib and letrozole. While on treatment, she developed hypopigmented lesions involving both hands, feet, and face, which were described as vitiligo-like lesions.Conclusion: CDK4/6 inhibitor-induced vitiligo is a rare and unpredictable adverse event. This case report highlights the rarity of this adverse event, the dilemma related to the optimal treatment, and decisions related to continuation, holding, or switching CDK4/6 inhibitors.Keywords: CDK4/6 inhibitors, ribociclib, vitiligo, vitiligo-like, breast cancer, skin adverse eventshttps://www.dovepress.com/vitiligo-like-lesions-in-a-patient-with-metastatic-breast-cancer-treat-peer-reviewed-fulltext-article-CCIDcdk4/6 inhibitorsribociclibvitiligovitiligo-likebreast cancerskin adverse events
spellingShingle Sharaf B
AlMasri R
Abdel-Razeq N
Salama O
Hamad I
Abunasser M
Abdel-Razeq H
Vitiligo-Like Lesions in a Patient with Metastatic Breast Cancer Treated with Cyclin-Dependent Kinase (CDK) 4/6 Inhibitor: A Case Report and Literature Review
Clinical, Cosmetic and Investigational Dermatology
cdk4/6 inhibitors
ribociclib
vitiligo
vitiligo-like
breast cancer
skin adverse events
title Vitiligo-Like Lesions in a Patient with Metastatic Breast Cancer Treated with Cyclin-Dependent Kinase (CDK) 4/6 Inhibitor: A Case Report and Literature Review
title_full Vitiligo-Like Lesions in a Patient with Metastatic Breast Cancer Treated with Cyclin-Dependent Kinase (CDK) 4/6 Inhibitor: A Case Report and Literature Review
title_fullStr Vitiligo-Like Lesions in a Patient with Metastatic Breast Cancer Treated with Cyclin-Dependent Kinase (CDK) 4/6 Inhibitor: A Case Report and Literature Review
title_full_unstemmed Vitiligo-Like Lesions in a Patient with Metastatic Breast Cancer Treated with Cyclin-Dependent Kinase (CDK) 4/6 Inhibitor: A Case Report and Literature Review
title_short Vitiligo-Like Lesions in a Patient with Metastatic Breast Cancer Treated with Cyclin-Dependent Kinase (CDK) 4/6 Inhibitor: A Case Report and Literature Review
title_sort vitiligo like lesions in a patient with metastatic breast cancer treated with cyclin dependent kinase cdk 4 6 inhibitor a case report and literature review
topic cdk4/6 inhibitors
ribociclib
vitiligo
vitiligo-like
breast cancer
skin adverse events
url https://www.dovepress.com/vitiligo-like-lesions-in-a-patient-with-metastatic-breast-cancer-treat-peer-reviewed-fulltext-article-CCID
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