Stevens-Johnson syndrome–like eruption from palbociclib in a patient with metastatic breast cancer

Karagounis, Theodora K; Vallurupalli, Mounica; Nathan, Neera; Nazarian, Rosalynn M.; Vedak, Priyanka; Spring, Laura; Chen, Shuo

doi:10.1016/j.jdcr.2017.12.015

Cited by 19 publications

(16 citation statements)

References 13 publications

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“…The most common skin toxicities are grade 1, ranging from mild urticaria to pityriasis. More severe (grade 3) skin rash was less than 1% so far in the clinical literature as we found only one case of severe cutaneous toxicity presented as Stevens-Johnson syndrome [1]. Acute bullous skin rash is very rare and warrants immediate discontinuation of palbociclib.…”

Section: Introductionmentioning

confidence: 74%

Bullous Skin Rash: A Rare Case of Palbociclib-Induced Dermatological Toxicity

Khan¹,

Alsharedi²

2020

Cureus

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Palbociclib is an FDA-approved cyclin-dependent kinase inhibitor to treat hormone-positive, HER2-negative metastatic breast cancer. Severe skin toxicities are rare but important adverse events associated with these agents. Early detection of severe forms of skin lesions is crucial to permit the immediate discontinuation of palbociclib in order to avoid unacceptable risk level in the form of severe cutaneous toxicities like Steven-Johnson Syndrome. In such cases, palbociclib should be abruptly discontinued and an early aggressive support should be initiated. We here present a case of 50-year-old Caucasian female, who developed acute onset blistering skin lesions one to two weeks after she was started on palbociclib. We sought to report this case given the unusual toxicity and to emphasize the importance of identifying the acute onset of blistering skin lesions, regardless of their extension, should prompt awareness of their potential severity.

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Section: Introductionmentioning

confidence: 74%

Bullous Skin Rash: A Rare Case of Palbociclib-Induced Dermatological Toxicity

Khan¹,

Alsharedi²

2020

Cureus

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“…Ribociclib is a newly approved cycline-dependent kinase 4 and 6 (CDK 4/6) inhibitor used in the setting of locally advanced or metastatic hormone-dependent and Her2-negative breast cancer. Thus far, 2 main cases of the SJS spectrum related to the CDK 4/6 inhibitors ribociclib and palbociclib have been reported [34]. We hereby present a second case of SJS related to ribociclib that started with mild cutaneous irritation with subacute worsening and final spread.…”

Section: Introductionmentioning

confidence: 82%

“…Herein, we have presented a case of CDK 4/6 inhibitor ribociclib-mediated SJS. The literature published thus far includes 2 different CDK 4/6-related SJS cases [34]. We would like to emphasize the importance of the multidisciplinary management of oncologic patients in light of the complexity of their medical condition.…”

Section: Discussionmentioning

confidence: 99%

Ribociclib-Related Stevens–Johnson Syndrome: Oncologic Awareness, Case Report, and Literature Review

et al. 2019

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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis belong to a severe dermatopathic spectrum that includes frequently fatal mucocutaneous manifestations consisting of whole epidermal necrosis and sloughing with bullous transformation, blistering, and further skin detachment. Notably, cancer patients are at higher risk of developing SJS than the general population as a consequence of both the nature of neoplastic disease and frequent exposure to anticancer drugs. Ribociclib is a newly approved cycline-dependent kinase inhibitor that has been recently associated with a single case of SJS. We hereby present a case of ribociclib-related SJS. Early detection of threatening skin lesions is crucial to permit the immediate discontinuation of ribociclib given the predictable and unacceptable risk level. In cases of established SJS, early aggressive support should be initiated, ribociclib should be abruptly discontinued, and specific treatment based on actual evidence should be started.

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“…As with the ALK inhibitors above, mild rash has been noted in some patients utilizing CDK 4/6 inhibitors. Rash with the use of these agents is rarely severe, though case reports of Stevens-Johnson syndrome have been noted in the literature (30). (35,36).…”

Section: Anaplastic Lymphoma Kinase (Alk) Inhibitorsmentioning

confidence: 99%

Cutaneous toxicities of new targeted cancer therapies: must know for diagnosis, management, and patient-proxy empowerment

McFarlane¹,

Rehman²,

Wang³

et al. 2020

Ann Palliat Med

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The world of oncology treatment is rapidly changing, and with the investigation into and utilization of molecular signaling pathways for cancer treatment, many new targeted small-molecule oral agents have been introduced as therapies, with more new drugs appearing every year. These agents, while generally considered less toxic overall than traditional chemotherapy, are not without adverse effects. The authors undertook an extensive literature search to determine the incidence, severity, and management strategies for small-molecule oral targeted agents approved by the FDA between 2013 and 2018.Dermatologic adverse effects are among the most frequently seen with many of these targeted therapies, and may include rashes, palmar-plantar dysesthesia, alopecia, secondary skin malignancies, and hair and nail changes. Rarely, more severe cutaneous toxicities are seen, such as Stevens-Johnson Syndrome and toxic epidermal necrolysis. In many cases, there is no specific management strategy suggested in the literature for these toxicities, but frequent monitoring of the skin, prophylactic management of palmar-plantar dysesthesia, use of corticosteroids and/or antihistamines, and intervention with dose interruption are suggested depending on circumstance and severity. Patient education and timely intervention is warranted in order to ensure that patient treatment is optimized.

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Stevens-Johnson syndrome–like eruption from palbociclib in a patient with metastatic breast cancer

Cited by 19 publications

References 13 publications

Bullous Skin Rash: A Rare Case of Palbociclib-Induced Dermatological Toxicity

Bullous Skin Rash: A Rare Case of Palbociclib-Induced Dermatological Toxicity

Ribociclib-Related Stevens–Johnson Syndrome: Oncologic Awareness, Case Report, and Literature Review

Cutaneous toxicities of new targeted cancer therapies: must know for diagnosis, management, and patient-proxy empowerment

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