Naslov
Rechallenge with a different CDK 4/6 inhibitor after ribociclib induced hepatotoxicity
(Rechallenge with a different CDK 4/6 inhibitor after ribociclib induced hepatotoxicity)

Autori
Benčić, Jelena ; Čular, Katarina ; Bajan, Manuela ; Knez, Nora ; Lasta, Sven ; Popović, Marina ; Silovski, Tajana ; Dedić Plavetić, Natalija

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Liječnički vjesnik : glasilo Hrvatskoga liječničkog zbora, 142 (2020), Suppl 2 / Pleština, Stjepko ; Dedić Plavetić, Natalija ; Tomek, Dora - Zagreb : Hrvatski liječnički zbor, 2020, 85-86

Skup
12. kongres Hrvatskog društva za internističku onkologiju HLZ-a s međunarodnim sudjelovanjem

Mjesto i datum
Online ; Zagreb, Hrvatska, 23.11.2020. - 27.11.2020

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
CDK4/6 ; rechallenge ; ribociclib ; hepatotoxicity

Sažetak
CDK 4/6 inhibitors are indicated in combination with fulvestrant or an aromatase inhibitor for the treatment of women with HR-positive HER2-negative advanced or metastatic breast cancer. Although all three CDK 4/6 inhibitors can cause drug-induced liver injury, it tends to be more pronounced with ribociclib. Methods: Clinical data from 79 breast cancer patients treated with ribociclib at the University Hospital Centre Zagreb from August, 2018 till November, 2020 were retrospectively examined. Result: The median age of the patients was 61 years. 33 patients had de novo metastatic breast cancer. 16 patients had liver metastases. An increase in aminotransferase levels (grade 3 or 4) was observed in 7 patients, mean age 62.7 years. Four patients had de novo metastatic breast cancer, 1 had liver metastases. In 1 patient ribociclib was permanently discontinued due to grade 4 hepatotoxicity, without subsequent aminotransferase normalization during follow-up. 6 patients developed grade 3 hepatotoxicity, for which treatment had to be permanently discontinued in 5 of them even after treatment interruption and dose adjustment. All 5 patients were on an aromatase inhibitor in addition to ribociclib and received a median of 4 cycles before discontinuation. Except in one patient in whom aminotransferases were persistently elevated during follow-up, the average time to enzyme recovery in others was 2.5 months. 3 patients switched from ribociclib to palbociclib and fulvestrant, and 1 to abemaciclib and fulvestrant. No hepatotoxicity was observed after the drug switch. Conclusion: Grade 3 and 4 hepatotoxicity occured in 8.8% of patients treated with ribociclib at the University Hospital Centre Zagreb, which is slightly lower than reported in MONALEESA trials (11.4%). In patients who require permanent discontinuation of ribociclib due to drug-induced liver injury, switching to another CDK 4/6 inhibitor could improve the side effects while maintaining the treatment benefit.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA