Türkel Alper, Özdoğan Sibel, Yekedüz Emre, Şeyran Erdoğan, Karaçin Cengiz, Ateş Öztürk
Division of Medical Oncology, 146995Dr. Abdurrahman Yurtaslan Ankara Oncology Research and Training Hospital, Ankara, Turkey.
Division of Ophthalmology, 146995Dr. Abdurrahman Yurtaslan Ankara Oncology Research and Training Hospital, Ankara, Turkey.
J Oncol Pharm Pract. 2023 Jan;29(1):230-232. doi: 10.1177/10781552221101799. Epub 2022 May 16.
Cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitors are the new generation drugs that have been started to be used in our clinical practice recently. These drugs have been shown to have better progression-free survival compared to standard therapy in patients with hormone receptor-positive (HR) and human epidermal growth factor receptor 2 (HER-2)-negative breast cancer. The most common side effects of CDK 4-6 inhibitors are neutropenia, nausea, leukopenia, fatigue, and diarrhea. This case demonstrated vortex keratopathy in both eyes, a rare condition in patients with breast cancer treated with ribociclib.
A 68-year-old female patient was diagnosed with locally advanced HR (+)/HER2 (-) breast cancer in March 2015. In June 2021, bone metastases were detected. The patient was started on ribociclib and fulvestrant. After three cycles of ribociclib and fulvestrant treatment, she was admitted with the complaint of blurred vision in her left eye. Slit-lamp biomicroscopy examination revealed subepithelial haze with central subepithelial whorls in both corneas, more in the left eye, and also a mild punctate epithelial staining was observed with the application of fluorescein dye.
Ribociclib treatment was immediately discontinued and no changes were observed in the cornea and vision levels during the one-month follow-up.
Routine and regular follow-up eye examinations in breast cancer patients treated with ribociclib may benefit patients in our daily clinical practice and may help us to detect side effects at an early stage and to manage them more effectively.
细胞周期蛋白依赖性激酶4和6（CDK4/6）抑制剂是近年来开始应用于临床实践的新一代药物。在激素受体阳性（HR）和人表皮生长因子受体2（HER-2）阴性乳腺癌患者中，这些药物已被证明与标准治疗相比具有更好的无进展生存期。CDK4-6抑制剂最常见的副作用是中性粒细胞减少、恶心、白细胞减少、疲劳和腹泻。本病例显示双眼出现涡状角膜病变，这在接受瑞博西尼治疗的乳腺癌患者中是一种罕见情况。
一名68岁女性患者于2015年3月被诊断为局部晚期HR（+）/HER2（-）乳腺癌。2021年6月，检测到骨转移。患者开始接受瑞博西尼和氟维司群治疗。在接受三个周期的瑞博西尼和氟维司群治疗后，她因左眼视力模糊的主诉入院。裂隙灯生物显微镜检查显示双眼角膜上皮下有 haze，中央有上皮下漩涡，左眼更明显，应用荧光素染料后还观察到轻度点状上皮染色。
立即停用瑞博西尼治疗，在为期一个月的随访期间，角膜和视力水平未观察到变化。
在接受瑞博西尼治疗的乳腺癌患者中进行常规和定期的眼部检查，可能会使我们日常临床实践中的患者受益，并可能帮助我们早期发现副作用并更有效地进行管理。
