Palbociclib-induced severe hepatitis: A case study and literature review.

Canadian liver journal Pub Date : 2021-11-11 eCollection Date: 2021-01-01 DOI:10.3138/canlivj-2021-0015
Jessie Jean Hyppolite, Nir Hilzenrat
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Abstract

Palbociclib is a selective and reversible CDK4/6 inhibitor approved for patients presenting with HR+ HER2- locally advanced or metastatic breast cancer. Its adverse effect (AE) is mainly reported on the occurrence of leukopenia and fatigue. Even though palbociclib has an extensive hepatic metabolism, there are rare reports about significant liver toxicity. We present the case of a 61-year-old female with metastatic breast cancer treated with palbociclib and an aromatase inhibitor (letrozole). The patient developed a rare AE of severe acute drug-induced hepatitis but improved dramatically after stopping the palbociclib and receiving treatment with N-acetylcysteine (NAC). The treatment with NAC may be a proof of concept for the mechanism of palbociclib liver injury.

帕博西尼(Palbociclib)诱发的重症肝炎:病例研究与文献综述
帕博西尼(Palbociclib)是一种选择性和可逆性CDK4/6抑制剂,已被批准用于治疗HR+ HER2-局部晚期或转移性乳腺癌患者。其不良反应(AE)主要表现为白细胞减少和疲劳。尽管帕博西尼(palbociclib)具有广泛的肝脏代谢能力,但有关其显著肝脏毒性的报道并不多见。我们报告了一例 61 岁女性转移性乳腺癌患者的病例,患者接受了 palbociclib 和芳香化酶抑制剂(来曲唑)治疗。患者出现了严重急性药物性肝炎的罕见 AE,但在停用帕博西尼并接受 N-乙酰半胱氨酸(NAC)治疗后病情明显好转。使用 NAC 治疗可能证明了帕博西尼肝损伤机制的概念。
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