Türkel Alper, Karaçin Cengiz, Öner İrem, Şeyran Erdoğan, Öksüzoğlu Berna
Division of Medical Oncology, 146995Dr. Abdurrahman Yurtaslan Ankara Oncology Research and Training Hospital, Ankara, Turkey.
J Oncol Pharm Pract. 2023 Feb 9:10781552231156521. doi: 10.1177/10781552231156521.
Cyclin-dependent kinase 4/6 inhibitors are new generation drugs that have recently been used in patients with hormone receptor-positive and human epidermal growth factor receptor 2-negativenegative metastatic breast cancer. Recent studies have shown that the use of cyclin-dependent kinase 4/6 inhibitors significantly improves the outcomes of these patients. The most common side effects of cyclin-dependent kinase 4/6 inhibitors are hematological toxicity, gastrointestinal side effects, and fatigue. We aimed to present a case of metastatic breast cancer who was treated with ribociclib and developed vitiligo-like lesions after treatment.
A 56-year-old female patient was diagnosed with locally advanced hormone receptor (+)/human epidermal growth factor receptor 2 (-) breast cancer in May 2000. She was followed up with hormonal therapy after adjuvant chemotherapy and radiotherapy. The patient progressed with lung metastases in 2012. Ribociclib, anastrozole, and leuprolide acetate were started in November 2021 after multiple-line chemotherapy. After six cycles of ribociclib, vitiligo-like lesions that developed in the last 1 month were detected on the upper extremities, both hands, neck, chest, and upper back.
The patient was referred to dermatology. Topical immunosuppressive therapy and oral corticosteroids were recommended. At the first and third-month follow-up examinations, vitiligo-like lesions were observed to persist.
Vitiligo-like lesions are not a life-threatening side effect. However, it significantly affects the quality of life and disrupts the patient's compliance with treatment. Cyclin-dependent kinase 4/6 inhibitors can inhibit cell division or cause premature cell death by acting on the melanocyte cell cycle.
细胞周期蛋白依赖性激酶4/6抑制剂是新一代药物，最近已用于激素受体阳性和人表皮生长因子受体2阴性的转移性乳腺癌患者。最近的研究表明，使用细胞周期蛋白依赖性激酶4/6抑制剂可显著改善这些患者的治疗效果。细胞周期蛋白依赖性激酶4/6抑制剂最常见的副作用是血液学毒性、胃肠道副作用和疲劳。我们旨在介绍一例转移性乳腺癌患者，该患者接受了瑞博西尼治疗，并在治疗后出现了白癜风样病变。
一名56岁女性患者于2000年5月被诊断为局部晚期激素受体（+）/人表皮生长因子受体2（-）乳腺癌。她在辅助化疗和放疗后接受激素治疗随访。该患者于2012年出现肺转移。在进行多线化疗后，于2021年11月开始使用瑞博西尼、阿那曲唑和醋酸亮丙瑞林。在接受六个周期的瑞博西尼治疗后，在最后1个月出现的白癜风样病变在双上肢、双手、颈部、胸部和上背部被发现。
该患者被转诊至皮肤科。建议采用局部免疫抑制治疗和口服糖皮质激素。在第一次和第三个月的随访检查中，白癜风样病变持续存在。
白癜风样病变不是危及生命的副作用。然而，它会显著影响生活质量并破坏患者的治疗依从性。细胞周期蛋白依赖性激酶4/6抑制剂可通过作用于黑素细胞周期来抑制细胞分裂或导致细胞过早死亡。
