Ribociclib in the first‑line therapy of hormone‑dependent generalized breast cancer in a young patient with liver toxicity – case report

06/2020

MUDr. Michaela Miškovičová

Onkologická klinika 1. LF UK a VFN, Praha

SUMMARY

The case report describes the case of a young premenopausal patient with hormone-dependent, HER2-negative breast cancer diagnosed in the stage of generalization to the skeleton and lymph nodes. Due to the extent of disease, no risk of visceral crisis and histopathological characteristics of the tumor, a combination of the cyclin-dependent kinase 4/6 (CDK4/6) inhibitor ribociclib with the aromatase inhibitor letrozole and a luteinizing hormone-releasing hormone (LHRH) agonist was selected for first line palliative therapy. This treatment has very promising results from randomized trials in which the ribociclib arms show significant long-term superiority over hormonal treatment alone. The effectiveness and benefit of treatment is evident in our patient, the use of therapy is initially complicated by severe hepatotoxicity, but the etiology in this case is very suspiciously multifactorial. After a slight adjustment of the dosage and careful monitoring of liver parameters, she continues the therapy with very good tolerance, now for the tenth cycle.

Key words

breast cancer, hormone therapy, CDK4/6 inhibitors, ribociclib, hepatotoxicity