Safety and efficacy of cyclin-dependent kinase inhibitor rechallenge following ribociclib-induced limiting hypertransaminasemia

Jesús Fuentes-Antrás; Alicia de Luna; Alfonso López de Sá; Alberto Ocaña; José Ángel García-Sáenz; Fernando Moreno

doi:10.1016/j.breast.2020.10.007

Safety and efficacy of cyclin-dependent kinase inhibitor rechallenge following ribociclib-induced limiting hypertransaminasemia

Breast. 2020 Dec:54:160-163. doi: 10.1016/j.breast.2020.10.007. Epub 2020 Oct 17.

Authors

Jesús Fuentes-Antrás¹, Alicia de Luna², Alfonso López de Sá², Alberto Ocaña³, José Ángel García-Sáenz², Fernando Moreno²

Affiliations

¹ Breast Cancer Unit, Department of Medical Oncology, San Carlos University Hospital, Madrid, Spain. Electronic address: [email protected].
² Breast Cancer Unit, Department of Medical Oncology, San Carlos University Hospital, Madrid, Spain.
³ Breast Cancer Unit, Department of Medical Oncology, San Carlos University Hospital, Madrid, Spain; Experimental Therapeutics and Translational Oncology Unit, Department of Medical Oncology, San Carlos University Hospital, Madrid, Spain.

Abstract

Cyclin-dependent kinase inhibitors (CDKIs) and endocrine therapy (ET) are the corner-stone of systemic therapy for patients with hormone-positive (HR+) HER2-negative metastatic breast cancer (MBC). However, limited data exist regarding rechallenge treatment strategies with CDKIs after limiting toxicity. In this report, we provide evidence of the safety and efficacy of sequential treatment with palbociclib or abemaciclib in 6 HR+/HER- MBC patients who experienced grade ≥3 ribociclib-induced hypertransaminasemia. Until results from large observational or randomized studies are communicated, empirical evidence may help make individualized decisions on CDKI rechallenge beyond ribociclib-induced unacceptable liver toxicity.

Keywords: CDK inhibitors; Hypertransaminasemia; Luminal; Metastatic breast cancer; Rechallenge.

Publication types

Evaluation Study

MeSH terms

Aminopyridines / administration & dosage*
Aminopyridines / adverse effects
Antineoplastic Agents / administration & dosage*
Antineoplastic Agents / adverse effects
Benzimidazoles / administration & dosage*
Breast Neoplasms / blood
Breast Neoplasms / drug therapy*
Chemical and Drug Induced Liver Injury / etiology
Cyclin-Dependent Kinase 4 / antagonists & inhibitors
Cyclin-Dependent Kinase 6 / antagonists & inhibitors
Drug Substitution
Female
Humans
Middle Aged
Piperazines / administration & dosage*
Protein Kinase Inhibitors / administration & dosage*
Protein Kinase Inhibitors / adverse effects
Purines / adverse effects
Pyridines / administration & dosage*
Receptors, Estrogen / metabolism
Receptors, Progesterone / metabolism
Retrospective Studies
Transaminases / blood
Transaminases / drug effects
Treatment Outcome

Substances

Aminopyridines
Antineoplastic Agents
Benzimidazoles
Piperazines
Protein Kinase Inhibitors
Purines
Pyridines
Receptors, Estrogen
Receptors, Progesterone
abemaciclib
Transaminases
Cyclin-Dependent Kinase 4
Cyclin-Dependent Kinase 6
palbociclib
ribociclib