Severe toxic rhabdomyolysis under combined palbociclib and simvastatin treatment: A case report

Area of Science:

• Oncology
• Pharmacology
• Toxicology

Background:

• Palbociclib is a cyclin-dependent kinase (CDK) 4/6 inhibitor used in cancer therapy.
• Statins, like simvastatin, are commonly prescribed for cholesterol management.
• Drug interactions between cancer therapies and other medications require careful monitoring.

Observation:

• An 81-year-old woman developed severe toxic rhabdomyolysis.
• The condition arose from the combined use of palbociclib (125 mg/day) and simvastatin.
• This represents the fourth reported case of rhabdomyolysis linked to palbociclib.

Findings:

• This is the first reported case of palbociclib-induced rhabdomyolysis successfully treated with plasma exchange.
• Complete functional recovery was achieved within two months post-treatment.
• The adverse event underscores a potential pharmacokinetic interaction between palbociclib and statins.

Implications:

• Further investigation into the interaction between CDK-4/6 inhibitors and statins is warranted.
• This case highlights the importance of evaluating drug-drug interactions in elderly patients with multiple prescriptions.
• Enhanced vigilance for rhabdomyolysis is crucial when prescribing palbociclib concurrently with statins.