Enhanced dermatologic toxicity following concurrent treatment with palbociclib and radiation therapy: A case report

Research output: Contribution to journalArticle

Jay A. Messer, Ekim Ekinci, Tejal A. Patel, Bin S. Teh

Background: Cyclin-dependent kinase (CDK) 4/6 inhibitors represent a new class of targeted therapy options for the treatment of estrogen receptor-positive (ER+) human epidermal growth factor 2-negative (HER2-) metastatic breast cancer. There are currently no published prospective data on the safety of use of radiation treatment with palbociclib. Case: We describe the case of a patient with metastatic breast cancer who received radiation treatment to a metastatic supraclavicular lymph node to planned 60 Gy in 30 fractions while on palbociclib, a selective inhibitor of CDK4/6. The patient developed early radiation toxicities including esophagitis and dermatitis that progressed to a severe left neck skin breakdown in the radiation field, resulting in the need for hospitalization. She had a break in treatment but was able to finish the radiation without palbociclib. Her tumor responded well to the treatment and her side effects healed. Discussion: To our knowledge this is the first case to report on concurrent palbociclib and radiation use, with resultant enhanced radiation effects that required hospitalization for symptom management. Several preclinical studies have shown synergistic effects of radiation and both in vivo and in vitro experiments resulting in improved survival and decreased cell proliferation, respectively, through enhanced G1 cell cycle arrest. Conclusion: This case highlights the importance of using caution when combining radiation with the new targeted therapies. Until more data becomes available, physicians are recommended to exercise clinical judgment when deciding on whether to continue or discontinue a CDK4/6 inhibitor in a patient who may need radiation.

Original languageEnglish (US)
Pages (from-to)276-280
Number of pages5
JournalReports of Practical Oncology and Radiotherapy
Volume24
Issue number3
DOIs
StatePublished - May 1 2019

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Enhanced dermatologic toxicity following concurrent treatment with palbociclib and radiation therapy : A case report. / Messer, Jay A.; Ekinci, Ekim; Patel, Tejal A.; Teh, Bin S.

In: Reports of Practical Oncology and Radiotherapy, Vol. 24, No. 3, 01.05.2019, p. 276-280.

Research output: Contribution to journalArticle

Harvard

Messer, JA, Ekinci, E, Patel, TA & Teh, BS 2019, 'Enhanced dermatologic toxicity following concurrent treatment with palbociclib and radiation therapy: A case report' Reports of Practical Oncology and Radiotherapy, vol. 24, no. 3, pp. 276-280. https://doi.org/10.1016/j.rpor.2019.03.001

APA

Messer, J. A., Ekinci, E., Patel, T. A., & Teh, B. S. (2019). Enhanced dermatologic toxicity following concurrent treatment with palbociclib and radiation therapy: A case report. Reports of Practical Oncology and Radiotherapy, 24(3), 276-280. https://doi.org/10.1016/j.rpor.2019.03.001

Vancouver

Messer JA, Ekinci E, Patel TA, Teh BS. Enhanced dermatologic toxicity following concurrent treatment with palbociclib and radiation therapy: A case report. Reports of Practical Oncology and Radiotherapy. 2019 May 1;24(3):276-280. https://doi.org/10.1016/j.rpor.2019.03.001

Author

Messer, Jay A. ; Ekinci, Ekim ; Patel, Tejal A. ; Teh, Bin S. / Enhanced dermatologic toxicity following concurrent treatment with palbociclib and radiation therapy : A case report. In: Reports of Practical Oncology and Radiotherapy. 2019 ; Vol. 24, No. 3. pp. 276-280.

BibTeX

@article{ccbfcffc0d2c46218e316515863fd480,
title = "Enhanced dermatologic toxicity following concurrent treatment with palbociclib and radiation therapy: A case report",
abstract = "Background: Cyclin-dependent kinase (CDK) 4/6 inhibitors represent a new class of targeted therapy options for the treatment of estrogen receptor-positive (ER+) human epidermal growth factor 2-negative (HER2-) metastatic breast cancer. There are currently no published prospective data on the safety of use of radiation treatment with palbociclib. Case: We describe the case of a patient with metastatic breast cancer who received radiation treatment to a metastatic supraclavicular lymph node to planned 60 Gy in 30 fractions while on palbociclib, a selective inhibitor of CDK4/6. The patient developed early radiation toxicities including esophagitis and dermatitis that progressed to a severe left neck skin breakdown in the radiation field, resulting in the need for hospitalization. She had a break in treatment but was able to finish the radiation without palbociclib. Her tumor responded well to the treatment and her side effects healed. Discussion: To our knowledge this is the first case to report on concurrent palbociclib and radiation use, with resultant enhanced radiation effects that required hospitalization for symptom management. Several preclinical studies have shown synergistic effects of radiation and both in vivo and in vitro experiments resulting in improved survival and decreased cell proliferation, respectively, through enhanced G1 cell cycle arrest. Conclusion: This case highlights the importance of using caution when combining radiation with the new targeted therapies. Until more data becomes available, physicians are recommended to exercise clinical judgment when deciding on whether to continue or discontinue a CDK4/6 inhibitor in a patient who may need radiation.",
keywords = "Breast cancer, Palbociclib, Radiosensitizing, Radiotherapy",
author = "Messer, {Jay A.} and Ekim Ekinci and Patel, {Tejal A.} and Teh, {Bin S.}",
year = "2019",
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RIS

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T1 - Enhanced dermatologic toxicity following concurrent treatment with palbociclib and radiation therapy

T2 - Reports of Practical Oncology and Radiotherapy

AU - Messer, Jay A.

AU - Ekinci, Ekim

AU - Patel, Tejal A.

AU - Teh, Bin S.

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Background: Cyclin-dependent kinase (CDK) 4/6 inhibitors represent a new class of targeted therapy options for the treatment of estrogen receptor-positive (ER+) human epidermal growth factor 2-negative (HER2-) metastatic breast cancer. There are currently no published prospective data on the safety of use of radiation treatment with palbociclib. Case: We describe the case of a patient with metastatic breast cancer who received radiation treatment to a metastatic supraclavicular lymph node to planned 60 Gy in 30 fractions while on palbociclib, a selective inhibitor of CDK4/6. The patient developed early radiation toxicities including esophagitis and dermatitis that progressed to a severe left neck skin breakdown in the radiation field, resulting in the need for hospitalization. She had a break in treatment but was able to finish the radiation without palbociclib. Her tumor responded well to the treatment and her side effects healed. Discussion: To our knowledge this is the first case to report on concurrent palbociclib and radiation use, with resultant enhanced radiation effects that required hospitalization for symptom management. Several preclinical studies have shown synergistic effects of radiation and both in vivo and in vitro experiments resulting in improved survival and decreased cell proliferation, respectively, through enhanced G1 cell cycle arrest. Conclusion: This case highlights the importance of using caution when combining radiation with the new targeted therapies. Until more data becomes available, physicians are recommended to exercise clinical judgment when deciding on whether to continue or discontinue a CDK4/6 inhibitor in a patient who may need radiation.

AB - Background: Cyclin-dependent kinase (CDK) 4/6 inhibitors represent a new class of targeted therapy options for the treatment of estrogen receptor-positive (ER+) human epidermal growth factor 2-negative (HER2-) metastatic breast cancer. There are currently no published prospective data on the safety of use of radiation treatment with palbociclib. Case: We describe the case of a patient with metastatic breast cancer who received radiation treatment to a metastatic supraclavicular lymph node to planned 60 Gy in 30 fractions while on palbociclib, a selective inhibitor of CDK4/6. The patient developed early radiation toxicities including esophagitis and dermatitis that progressed to a severe left neck skin breakdown in the radiation field, resulting in the need for hospitalization. She had a break in treatment but was able to finish the radiation without palbociclib. Her tumor responded well to the treatment and her side effects healed. Discussion: To our knowledge this is the first case to report on concurrent palbociclib and radiation use, with resultant enhanced radiation effects that required hospitalization for symptom management. Several preclinical studies have shown synergistic effects of radiation and both in vivo and in vitro experiments resulting in improved survival and decreased cell proliferation, respectively, through enhanced G1 cell cycle arrest. Conclusion: This case highlights the importance of using caution when combining radiation with the new targeted therapies. Until more data becomes available, physicians are recommended to exercise clinical judgment when deciding on whether to continue or discontinue a CDK4/6 inhibitor in a patient who may need radiation.

KW - Breast cancer

KW - Palbociclib

KW - Radiosensitizing

KW - Radiotherapy

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SN - 1507-1367

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