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Delayed-Onset Vitiligo in Metastatic HR+/HER2- Breast Cancer During Long-Term Ribociclib Therapy.
Elias Tayar1, Dhatri Kodali1,2
1Department of Internal Medicine, HCA Healthcare Clear Lake, Houston, USA.
Vitiligo, a rare skin side effect of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors, can occur even after years of treatment. This case shows that mild vitiligo does not require stopping effective cancer therapy.
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Area of Science:
- Oncology
- Dermatology
- Pharmacology
Background:
- Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors are used to treat hormone receptor-positive, HER2-negative breast cancer.
- Vitiligo is a rare but recognized cutaneous adverse event associated with CDK4/6 inhibitor therapy.
Purpose of the Study:
- To report a case of delayed-onset vitiligo in a patient receiving long-term CDK4/6 inhibitor therapy.
- To emphasize that vitiligo does not necessitate treatment discontinuation if managed conservatively.
Main Methods:
- Case report of a 56-year-old woman with metastatic breast cancer treated with ribociclib.
- Dermatologic evaluation and conservative management with topical corticosteroids.
Main Results:
- The patient developed asymptomatic vitiligo after 3 years of ribociclib therapy.
- Metastatic disease remained stable with continued ribociclib treatment and conservative management of vitiligo.
Conclusions:
- Delayed-onset vitiligo is an uncommon immune-mediated toxicity of prolonged CDK4/6 inhibitor use.
- Mild cutaneous autoimmune-like toxicities do not warrant stopping effective anticancer drugs.
- Collaborative management between oncologists and dermatologists is essential for CDK4/6 inhibitor-associated vitiligo.