Jagadish Ishitha, Newell Phoebe, Khong Hung Thieu
Internal Medicine, Banner - University Medical Center Phoenix, Phoenix, Arizona, USA.
Breast Cancer Program, Banner MD Anderson Cancer Center, Gilbert, Arizona, USA
BMJ Case Rep. 2025 Aug 21;18(8):e263176. doi: 10.1136/bcr-2024-263176.
Cyclin-dependent kinase 4/6 inhibitors (CDK4/6Is), including ribociclib, are used alongside endocrine therapy for hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative metastatic breast cancer. Ribociclib-induced colitis is a rare drug reaction with unknown incidence, lack of discovery in clinical trials, and only one other published case. We describe a case of ribociclib-induced colitis and subsequent management. A female with metastatic HR+ breast cancer in her 60s was prescribed letrozole and ribociclib. She developed acute diarrhea, and a surveillance CT demonstrated pan-colitis. After discontinuing ribociclib and completing steroids, the diarrhea resolved. Palbociclib, an alternative CDK4/6I, was initiated as replacement. The patient tolerated palbociclib for up to 5 months at the time of publication without recurrence of colitis. Postmarket drug surveillance is crucial to prevent diagnostic delays. An investigation into CDK4/6-induced colitis, relative risks between agents, and potential risk factors is needed.
细胞周期蛋白依赖性激酶4/6抑制剂（CDK4/6Is），包括瑞博西尼，与内分泌疗法联合用于激素受体阳性（HR+）和人表皮生长因子受体2阴性的转移性乳腺癌。瑞博西尼诱发的结肠炎是一种罕见的药物反应，其发病率未知，在临床试验中未被发现，仅有另外一例已发表的病例。我们描述了一例瑞博西尼诱发的结肠炎及后续治疗情况。一名60多岁患有转移性HR+乳腺癌的女性患者被处方来曲唑和瑞博西尼。她出现了急性腹泻，监测CT显示全结肠炎。停用瑞博西尼并完成类固醇治疗后，腹泻症状缓解。作为替代药物，开始使用另一种CDK4/6I哌柏西利。在发表本文时，患者耐受哌柏西利长达5个月，结肠炎未复发。上市后药物监测对于防止诊断延误至关重要。需要对CDK4/6诱发的结肠炎、药物之间的相对风险以及潜在风险因素进行调查。
