Characteristic Hepatic Atrophy in Abemaciclib-Induced Liver Injury: A Comparative Review of Three Cases

Area of Science:

• Hepatology
• Oncology
• Radiology

Background:

• Abemaciclib is a standard treatment for hormone receptor-positive, HER2-negative breast cancer.
• Abemaciclib can induce liver dysfunction, a significant clinical concern.

Purpose of the Study:

• To report the first cases of drug-induced liver injury (DILI) from abemaciclib.
• To highlight the characteristic imaging findings of rapid-onset hepatic atrophy in abemaciclib-induced liver injury.

Main Methods:

• Retrospective analysis of three breast cancer patients who developed liver dysfunction after starting abemaciclib.
• Review of clinical data and contrast-enhanced CT (CECT) scans to identify imaging characteristics.
• Correlation of imaging findings with clinical outcomes and treatment responses.

Main Results:

• Three cases of abemaciclib-induced liver injury presented with characteristic liver atrophy and Chilaiditi syndrome on CECT scans.
• Patients developed liver dysfunction or acute liver failure within two months of initiating abemaciclib.
• Outcomes varied, with some patients experiencing improvement with treatment while others faced disease progression or liver failure.

Conclusions:

• This report is the first to describe the imaging features of rapid-onset hepatic atrophy associated with abemaciclib-induced liver injury.
• Recognizing these imaging characteristics may aid in differentiating abemaciclib-induced liver injury from other causes of liver dysfunction.
• Further research is needed to understand the mechanisms and optimize management of abemaciclib-induced liver injury.