Medicina (Apr 2023)

Does the Rechallenge with Another CDK 4/6 Inhibitor in Breast Cancer Work? A Case Report and Literature Review

  • 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

DOI
https://doi.org/10.3390/medicina59040696
Journal volume & issue
Vol. 59, no. 4
p. 696

Abstract

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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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