open access

Vol 24, No 3 (2019)
Published online: 2019-05-01
Submitted: 2018-10-05
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Enhanced dermatologic toxicity following concurrent treatment with palbociclib and radiation therapy: A case report

Jay A. Messer, Ekim Ekinci, Tejal A. Patel, Bin S. Teh
DOI: 10.1016/j.rpor.2019.03.001
·
Rep Pract Oncol Radiother 2019;24(3):276-280.

open access

Vol 24, No 3 (2019)
Published online: 2019-05-01
Submitted: 2018-10-05

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 60Gy 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.

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 60Gy 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.

Get Citation

Keywords

Radiotherapy; Palbociclib; Radiosensitizing; Breast cancer

About this article
Title

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

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 24, No 3 (2019)

Pages

276-280

Published online

2019-05-01

DOI

10.1016/j.rpor.2019.03.001

Bibliographic record

Rep Pract Oncol Radiother 2019;24(3):276-280.

Keywords

Radiotherapy
Palbociclib
Radiosensitizing
Breast cancer

Authors

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

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