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患有转移性乳腺癌的利博西克利布治疗患者的急性肝炎

Chika Iguh¹, Iqra Bakhsh¹, Sava Grujic¹

¹Department of Pathology and Laboratory Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, USA.

Journal of medical cases

|October 1, 2025

概括

由于 ribociclib (一种 CDK4/6 抑制剂) 的严重肝损伤是罕见的,但有可能发生. 这种病例显示了大量的肝脏亡,强调了早期识别和如果需要的话,用N-乙半氨酸 (NAC) 进行仔细的治疗.

科学领域:

在瘤学瘤学.
肝病学肝病学是一种肝病学.
药理学药理学是指药理学的学科.

背景情况:

利博西克利布是一种循环素依赖性激酶4/6 (CDK4/6) 抑制剂,用于HR+/HER2-转移性乳腺癌.
肝毒性是一种已知的副作用,但严重的肝损伤与次级肝硬化不常见.

研究的目的:

报告一种罕见的严重的 ribociclib 诱导的肝损伤病例.
突出早期识别和因果关系评估在治疗药物诱导的肝损伤方面的重要性.

主要方法:

一个经过更年期的女性转移性乳腺癌的案例研究,接受了 ribociclib 和 anastrozole 的治疗.
包括临床表现,实验室发现,肝活检结果和因果关系评估得分 (R-factor,RCAM,Naranjo).

主要成果:

患者患有急性肝细胞损伤,转氨酶显著升高和高 bilirubinemia.
肝脏活检证实了亚大规模肝脏亡;因果关系评估表明可能是 ribociclib 诱导.
停止服用 ribociclib 并启动 N-乙半氨酸 (NAC) 导致肝酶正常化.

结论:

利博西克利布可以导致严重的肝细胞损伤,包括次重性肝硬化.
早期诊断,因果关系评估和考虑NAC对于管理 ribociclib 诱导的肝损伤至关重要.
在严重的病例中,可能需要停止和不重复使用 ribociclib.

关键词:

乳腺新生体的形成.循环素依赖性激酶4和6抑制剂药物诱导的肝损伤是药物诱导的肝毒性肝毒性肝毒性肝脏活检活检是什么意思叶叶状癌瘤 (lobular carcinoma) 是一种癌症.这是一种N-乙囊氨酸.里博西克利布 (Ribociclib) 是一种可靠的药物.

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