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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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Autores principales: Stanciu, Ioana-Miruna, Pirlog, Cristina Florina, Anghel, Andrei-Wilhelm, Parosanu, Andreea Ioana, Olaru, Cristina Mihaela, Orlov-Slavu, Cristina, Iaciu, Ion Cristian, Popa, Ana Maria, Vrabie, Radu Constantin, Nitipir, Cornelia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10145154/
https://www.ncbi.nlm.nih.gov/pubmed/37109654
http://dx.doi.org/10.3390/medicina59040696
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author Stanciu, Ioana-Miruna
Pirlog, Cristina Florina
Anghel, Andrei-Wilhelm
Parosanu, Andreea Ioana
Olaru, Cristina Mihaela
Orlov-Slavu, Cristina
Iaciu, Ion Cristian
Popa, Ana Maria
Vrabie, Radu Constantin
Nitipir, Cornelia
author_facet Stanciu, Ioana-Miruna
Pirlog, Cristina Florina
Anghel, Andrei-Wilhelm
Parosanu, Andreea Ioana
Olaru, Cristina Mihaela
Orlov-Slavu, Cristina
Iaciu, Ion Cristian
Popa, Ana Maria
Vrabie, Radu Constantin
Nitipir, Cornelia
author_sort Stanciu, Ioana-Miruna
collection PubMed
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.
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spelling pubmed-101451542023-04-29 Does the Rechallenge with Another CDK 4/6 Inhibitor in Breast Cancer Work? A Case Report and Literature Review Stanciu, Ioana-Miruna Pirlog, Cristina Florina Anghel, Andrei-Wilhelm Parosanu, Andreea Ioana Olaru, Cristina Mihaela Orlov-Slavu, Cristina Iaciu, Ion Cristian Popa, Ana Maria Vrabie, Radu Constantin Nitipir, Cornelia Medicina (Kaunas) Case Report 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. MDPI 2023-04-01 /pmc/articles/PMC10145154/ /pubmed/37109654 http://dx.doi.org/10.3390/medicina59040696 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Stanciu, Ioana-Miruna
Pirlog, Cristina Florina
Anghel, Andrei-Wilhelm
Parosanu, Andreea Ioana
Olaru, Cristina Mihaela
Orlov-Slavu, Cristina
Iaciu, Ion Cristian
Popa, Ana Maria
Vrabie, Radu Constantin
Nitipir, Cornelia
Does the Rechallenge with Another CDK 4/6 Inhibitor in Breast Cancer Work? A Case Report and Literature Review
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 Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10145154/
https://www.ncbi.nlm.nih.gov/pubmed/37109654
http://dx.doi.org/10.3390/medicina59040696
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