The impact of cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) on the incidence of alopecia in patients with metastatic breast cancer (BC)

Eiger, Daniel; Wagner, Marcio; Pondé, Noam; Nogueira, Melanie Schmitt; Buisseret, Laurence; Azambuja, Evandro de

doi:10.1080/0284186x.2020.1738547

Cited by 9 publications

(2 citation statements)

References 16 publications

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“…The incidence of CAEs and pruritus was approximately 15%-20% of patients treated with CDK4/6i + ET, with very few grade ≥3 (<1%). 20 , 21 To date, there is little data on the characteristics of these skin manifestations and no information on their potential impact on the efficacy and outcome of the treatments. 18-20 , 22 …”

Section: Introductionmentioning

confidence: 99%

Ribociclib-Induced Cutaneous Adverse Events in Metastatic HR+/HER2− Breast Cancer: Incidence, Multidisciplinary Management, and Prognostic Implication

Borroni,

Bartolini,

Gaudio

et al. 2024

The Oncologist

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Background Ribociclib is approved for hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2−) advanced breast cancer (ABC) treatment, in combination with endocrine therapy. Hematological, hepatic, and cardiac adverse events (AEs) emerged from pivotal trials, but little is known about cutaneous adverse events (CAEs). Patients and Methods We report data from a retrospective cohort study of all patients with HR+/HER2− ABC treated with ribociclib at Humanitas Cancer Center between June 2017 and December 2022. We recorded clinical-pathological data, the incidence, and treatment of ribociclib-related CAEs. These were evaluated according to the NCI-CTCAE v5.0 classification. Progression-free survival (PFS) was estimated by Kaplan-Meier method and the log-rank test was used to analyze differences between groups. Results Thirteen of 91 patients (14.3%) experienced treatment-related CAEs (mean time to the occurrence: 3.9 months). The most frequent CAEs were eczematous dermatitis (53.8%) and maculo-papular reaction (15.4%). Itch was reported by all 13 patients. The grade was G3 in 8 cases, G2 in 4, and G1 in 1. An integrated approach based on ribociclib dose modulation and dermatological interventions (oral antihistamine, moisturized cream, topical, and/or systemic steroids) could prevent ribociclib discontinuation in most patients. At a median follow-up of 20 months, the median PFS was 13 months (range, 1-66) with a better PFS curves for patients experiencing CAEs (P = .04). Conclusion We mapped frequency and types of ribociclib-induced CAEs. An interdisciplinary management of CAEs incorporated into routine care may reduce the rate of drug discontinuation thus potentially contributing to better long-term outcomes.

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Section: Introductionmentioning

confidence: 99%

Ribociclib-Induced Cutaneous Adverse Events in Metastatic HR+/HER2− Breast Cancer: Incidence, Multidisciplinary Management, and Prognostic Implication

Borroni,

Bartolini,

Gaudio

et al. 2024

The Oncologist

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“…[14][15][16] A number of mild cutaneous adverse events, such as low-grade alopecia and skin rash, have been attributed to CDK4/6 inhibitors. 17 More severe skin toxicities are rare and constitute less than 1% of reported adverse events. 18,19 Vitiligo is a chronic acquired pigmentary skin disorder, characterized by the absence of pigmentary cells from the epidermis that leads to white patches on the body, usually symmetrically distributed, and is more obvious in people with dark skin.…”

Section: Introductionmentioning

confidence: 99%

Vitiligo-Like Lesions in a Patient with Metastatic Breast Cancer Treated with Cyclin-Dependent Kinase (CDK) 4/6 Inhibitor: A Case Report and Literature Review

Sharaf¹,

AlMasri²,

Abdel-Razeq³

et al. 2022

CCID

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Background: Cyclin-dependent kinase (CDK) 4/6 inhibitors have revolutionized the treatment landscape of hormone receptor-positive (HR + ), human epidermal growth factor receptor 2-negative (HER2 − ) metastatic breast cancer, with an impressive efficacy and safety profile. Cytopenia is the main adverse event, which is both predictable and manageable. Here, we report a case of CDK4/6 inhibitor-induced vitiligo-like lesions. Vitiligo or vitiligolike lesions are a rare adverse event; only a few cases are reported in the literature. Case Presentation: A 71-year-old female patient was diagnosed initially with early-stage right breast cancer (HR + /HER2 − ) and was treated with breast-conserving surgery followed by chemotherapy, radiotherapy, and hormonal therapy. A few years later, she developed metastatic disease to the hilar lymph nodes, and to multiple skeletal sites, including the left scapula, left shoulder, left iliac bone, and dorsal vertebrae, for which she was treated with ribociclib and letrozole. While on treatment, she developed hypopigmented lesions involving both hands, feet, and face, which were described as vitiligo-like lesions. Conclusion: CDK4/6 inhibitor-induced vitiligo is a rare and unpredictable adverse event. This case report highlights the rarity of this adverse event, the dilemma related to the optimal treatment, and decisions related to continuation, holding, or switching CDK4/6 inhibitors.

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Hair loss during and after breast cancer therapy

Rose

Lustberg

Ruddy

et al. 2023

Support Care Cancer

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The impact of cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) on the incidence of alopecia in patients with metastatic breast cancer (BC)

Cited by 9 publications

References 16 publications

Ribociclib-Induced Cutaneous Adverse Events in Metastatic HR+/HER2− Breast Cancer: Incidence, Multidisciplinary Management, and Prognostic Implication

Ribociclib-Induced Cutaneous Adverse Events in Metastatic HR+/HER2− Breast Cancer: Incidence, Multidisciplinary Management, and Prognostic Implication

Vitiligo-Like Lesions in a Patient with Metastatic Breast Cancer Treated with Cyclin-Dependent Kinase (CDK) 4/6 Inhibitor: A Case Report and Literature Review

Hair loss during and after breast cancer therapy

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