Cyclin 4/6 inhibitors (CDKIs) are currently used in patients with hormone-dependent breast cancer as first-line treatment for metastatic disease. One of their less frequent but equally limiting adverse events is skin toxicity. The purpose of the study was to report the incidence of skin toxicity in patients with breast cancer treated with CDKIs in our center.
Between November 2017 and December 2022, information from patients affected with metastatic breast cancer (MBC) treated with CDKIs at Hospital del Mar was retrospectively collected. A descriptive statistical analysis was performed. Toxicity was classified using CTCAE v5.0.
A total of 193 patients were included of whom 8.8% (17/193) presented some cutaneous reaction related to CDKIs. The median age at diagnosis of breast neoplasia was 53 years (range 40-84). Forty-seven percent (8/17 patients) had received Ribociclib while 53% had received Palbociclib. One patient required a change of CDKIs (from Ribociclib to Palbociclib) due to G2 skin reaction. The mean time between starting CDKIs and the appearance of the skin reaction was 10.8 months, with 64.7% (11/17) of the patients having a grade 2 reaction and 35.3% (6/17) having a grade 1 reaction. The most frequently observed skin lesions were cutaneous xerosis and prurigo lesions (4 patients), followed by eczema-like desquamative lesions (3 patients) and reactive or figured erythema (erythema multiforme [1], nonspecific erythematous plaques [3], granuloma annulare [1]). Other manifestations present in only one patient each were: morphea, bullous eruption, lichenoid eruption, hyperpigmentation and palmoplantar pustulosis. Five patients associated a second cutaneous manifestation: onychodystrophy (3), aphthosis (1) and palmoplantar keratoderma (1). Two of these patients presented a cutaneous reaction in relation to radiotherapy treatment, an effect known as radiation recall effect.
Although skin toxicity is not a very frequent reaction and in our series it did not lead to treatment discontinuation, it is necessary to monitor this toxicity and refer to dermatology when necessary in order not to discontinue the oncospecific treatment.
The authors.
Has not received any funding.
L.M. Masfarre Pinto: Non-Financial Interests, Institutional, Speaker’s Bureau: AstraZeneka; Non-Financial Interests, Institutional, Other, Travel expenses: MSD. N. Navarro Gorro: Non-Financial Interests, Institutional, Invited Speaker, Travel expenses: AstraZeneka, Kyowa Kirin; Non-Financial Interests, Institutional, Other, Travel expenses: MSD. J. Recuero: Non-Financial Interests, Institutional, Other, Travel expenses: Lilly. T. Martos Cardenas: Non-Financial Interests, Institutional, Other, Travel expenses: Pfizer. M. Martinez Garcia: Non-Financial Interests, Institutional, Other, Travel expenses: Roche, Pfizer; Non-Financial Interests, Institutional, Advisory Board: Roche, Celgene, Seagen, Boehringer, Pierre Fabre. M. Castro-Henriques Pinto-Machado: Non-Financial Interests, Institutional, Other, Travel expenses: Pfizer. N. Rodriguez de Dios: Non-Financial Interests, Institutional, Advisory Board: AstraZeneca; Non-Financial Interests, Institutional, Speaker’s Bureau: AstraZeneca, Siemens Healthineers. S. Servitja Tormo: Non-Financial Interests, Institutional, Speaker’s Bureau: Daiichi Sankyo, AstraZeneca, Roche, Novartis; Non-Financial Interests, Institutional, Advisory Board: Seagen , Genomic Health, MSD. All other authors have declared no conflicts of interest.