Efficacy of CDK4/6 Inhibitor in Treatment of Metastatic Breast Cancer and Colon Cancer

Janet Raycheva; Teodora Karanikolova; Rossitza Krusteva; Margarita Taushanova-Hadjieva

doi:doi:10.11648/j.ijcocr.20200501.11

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Efficacy of CDK4/6 Inhibitor in Treatment of Metastatic Breast Cancer and Colon Cancer

Janet Raycheva, Teodora Karanikolova, Rossitza Krusteva, Margarita Taushanova-Hadjieva

Published in International Journal of Clinical Oncology and Cancer Research (Volume 5, Issue 1)

Received: 21 October 2019 Accepted: 30 December 2019 Published: 8 January 2020

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Abstract

A 52-years old woman was diagnosed with an invasive left-sided ductal breast cancer, G3 – staged as T2N0M0; Estrogen (ER) 3+, Progesterone (PR) +, Human epidermal growth factor receptor 2 (HER 2) negative, Ki67-11%. She underwent a radical mastectomy, followed by adjuvant chemotherapy and hormone treatment with Tamoxifen. A year later she was diagnosed with a colorectal cancer-low grade, G1; histological results of adenocarcinoma - T3N1M1 with liver metastases. After a biopsy, which revealed that the metastases are coming from the breast (ER+/HER 2 (-) Breast cancer - (GATA (3+)), she was restaged as T3N1M0. The patient started treatment with Ribociclib 600mg/d + Letrozole 2,5mg/d with a partial response of the disease after three months of treatment. Due to G3 neutropenia, the dose was adjusted to 400 mg/d. Last restaging: October 2019 – complete response and a good quality of life. This case approves that the CDK (cyclin-dependent kinase) 4/6 inhibitors are able to manage visceral metastases and to provide long-term survival without worsening the quality of life. Her disease is successfully managed with CDK4/6 inhibitor together with hormonal therapy, which proves the effect of the CDK 4/6 inhibitors in treatment not only to breast cancer. Six months after there are no signs of relapse of the colon cancer. Despite the stage of the second cancer – T3N1M0, the patient did not undergo adjuvant treatment for the colon cancer.

Published in	International Journal of Clinical Oncology and Cancer Research (Volume 5, Issue 1)
DOI	10.11648/j.ijcocr.20200501.11
Page(s)	1-4
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Metastatic Breast Cancer, Colon Cancer, Hormone Therapy, Efficacy, Safety Profile

References

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[2]	E. Senkus, S. Kyriakides, S. Ohno, F. Penault-Llorca - “Primary Breast Cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up” doi: 10.1093/annonc/mdv298.
[3]	Koehler M, VanArsdale TL, Shields D, Arndt K, Yuan J, Lee N, Eisele K, Chionis J, Cao J, Painter CL. Mechanism of action for combined CDK4/6 and ER inhibition in ER positive breast cancer. Ann Oncol. 2014; 25: i21–i2.
[4]	Richard S. Finn, M. D., Miguel Martin, M. D., Hope S. Rugo, M. D. “Palbociclib and Letrozole in Advanced Breast cancer”.
[5]	Hortobagyi G, Stemmer S, Burris H et al. Ribociclib as first-line therapy for HR-positive, advanced breast cancer. N Engl J Med 2016 375 (18): 1738 –1748.
[6]	Michael S. Lee, Timothy L. Helms, Ningping Feng, Jason Gay, Qing Edward Chang “Efficacy of the combination of MEK and CDK4/6 inhibitors in vitro and in vivo in KRAS mutant colorectal cancer models.
[7]	Finn RS, Martin M, Rugo HS et al. Palbociclib and letrozole in advanced breast cancer. N Engl J Med 2016; 375 (20): 1925–1936.
[8]	Cristofanilli M, Turner NC, Bondarenko I et al. Fulvestrant plus palbociclib versus fulvestrant plus placebo for treatment of hormone-receptor-positive, HER2-negative metastatic breast cancer that progressed on previous endocrine therapy (PALOMA-3): final analysis of the multicentre, double-blind, phase 2 randomised controlled trial. Lancet Oncol 2016; 17 (4): 425– 439.
[9]	Updated results from MONALEESA-2, a phase III trial of first-line ribociclib plus letrozole versus placebo plus letrozole in hormone receptor-positive, HER2-negative advanced breast cancer - G N Hortobagyi, S M Stemmer, H A Burris, Y S Yap, G S Sonke, S Paluch-Shimon, M Campone, K Petrakova, K L Blackwell, E P Winer.
[10]	C L Lee, S Toomey, A Farrelly, B Hennessy “Preclinical drug testing and clinical trial planning of palbociclib (CDK4/6 inhibitor) drug combination with a PI3K or MAPK inhibitor for colorectal cancer (CRC); ” Annals of Oncology, Volume 30, Issue Supplement_1, February 2019, mdz029.012, https://doi.org/10.1093/annonc/mdz029.012; Published: 27 February 2019.
[11]	Amita Patnaik, Lee S. Rosen, Sara M. Tolaney, Efficacy and Safety of Abemaciclib, an Inhibitor of CDK4 and CDK6, for Patients with Breast Cancer, Non–Small Cell Lung Cancer, and Other Solid Tumors.
[12]	Elizabeth K. Ziemke, Joseph S. Dosch, Joel D. Maust, Amrith Shettigar, Ananda Sen, Theodore H. Welling, Karin M. Hardiman and Judith S. Sebolt-Leopold DOI: 10.1158/1078-0432. CCR-15-0829 Published January 2016: Sensitivity of KRAS-Mutant Colorectal Cancers to Combination Therapy That Cotargets MEK and CDK4/6.
[13]	Migliardi G, Sassi F, Torti D, Galimi F, Zanella ER, Buscarino M, Ribero D, Muratore A, Massucco P, Pisacane A, Risio M, Capussotti L, Marsoni S, et al. Inhibition of MEK and PI3K/mTOR suppresses tumor growth but does not cause tumor regression in patient-derived xenografts of RAS-mutant colorectal carcinomas. Clin Cancer Res. 2012; 18: 2515–25.
[14]	Mendoza MC, Er EE, Blenis J. The Ras-ERK and PI3K-mTOR pathways: cross-talk and compensation. Trends Biochem Sci 2011; 36: 320–328.
[15]	M Pek, S M J M Yatim, Y Chen, J Li, M Gong Oncogenic KRAS-associated gene signature defines co-targeting of CDK4/6 and MEK as a viable therapeutic strategy in colorectal cancer.

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APA Style

Janet Raycheva, Teodora Karanikolova, Rossitza Krusteva, Margarita Taushanova-Hadjieva. (2020). Efficacy of CDK4/6 Inhibitor in Treatment of Metastatic Breast Cancer and Colon Cancer. International Journal of Clinical Oncology and Cancer Research, 5(1), 1-4. https://doi.org/10.11648/j.ijcocr.20200501.11

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ACS Style

Janet Raycheva; Teodora Karanikolova; Rossitza Krusteva; Margarita Taushanova-Hadjieva. Efficacy of CDK4/6 Inhibitor in Treatment of Metastatic Breast Cancer and Colon Cancer. Int. J. Clin. Oncol. Cancer Res. 2020, 5(1), 1-4. doi: 10.11648/j.ijcocr.20200501.11

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AMA Style

Janet Raycheva, Teodora Karanikolova, Rossitza Krusteva, Margarita Taushanova-Hadjieva. Efficacy of CDK4/6 Inhibitor in Treatment of Metastatic Breast Cancer and Colon Cancer. Int J Clin Oncol Cancer Res. 2020;5(1):1-4. doi: 10.11648/j.ijcocr.20200501.11

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@article{10.11648/j.ijcocr.20200501.11,
  author = {Janet Raycheva and Teodora Karanikolova and Rossitza Krusteva and Margarita Taushanova-Hadjieva},
  title = {Efficacy of CDK4/6 Inhibitor in Treatment of Metastatic Breast Cancer and Colon Cancer},
  journal = {International Journal of Clinical Oncology and Cancer Research},
  volume = {5},
  number = {1},
  pages = {1-4},
  doi = {10.11648/j.ijcocr.20200501.11},
  url = {https://doi.org/10.11648/j.ijcocr.20200501.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20200501.11},
  abstract = {A 52-years old woman was diagnosed with an invasive left-sided ductal breast cancer, G3 – staged as T2N0M0; Estrogen (ER) 3+, Progesterone (PR) +, Human epidermal growth factor receptor 2 (HER 2) negative, Ki67-11%. She underwent a radical mastectomy, followed by adjuvant chemotherapy and hormone treatment with Tamoxifen. A year later she was diagnosed with a colorectal cancer-low grade, G1; histological results of adenocarcinoma - T3N1M1 with liver metastases. After a biopsy, which revealed that the metastases are coming from the breast (ER+/HER 2 (-) Breast cancer - (GATA (3+)), she was restaged as T3N1M0. The patient started treatment with Ribociclib 600mg/d + Letrozole 2,5mg/d with a partial response of the disease after three months of treatment. Due to G3 neutropenia, the dose was adjusted to 400 mg/d. Last restaging: October 2019 – complete response and a good quality of life. This case approves that the CDK (cyclin-dependent kinase) 4/6 inhibitors are able to manage visceral metastases and to provide long-term survival without worsening the quality of life. Her disease is successfully managed with CDK4/6 inhibitor together with hormonal therapy, which proves the effect of the CDK 4/6 inhibitors in treatment not only to breast cancer. Six months after there are no signs of relapse of the colon cancer. Despite the stage of the second cancer – T3N1M0, the patient did not undergo adjuvant treatment for the colon cancer.},
 year = {2020}
}

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TY - JOUR
T1 - Efficacy of CDK4/6 Inhibitor in Treatment of Metastatic Breast Cancer and Colon Cancer
AU - Janet Raycheva
AU - Teodora Karanikolova
AU - Rossitza Krusteva
AU - Margarita Taushanova-Hadjieva
Y1 - 2020/01/08
PY - 2020
N1 - https://doi.org/10.11648/j.ijcocr.20200501.11
DO - 10.11648/j.ijcocr.20200501.11
T2 - International Journal of Clinical Oncology and Cancer Research
JF - International Journal of Clinical Oncology and Cancer Research
JO - International Journal of Clinical Oncology and Cancer Research
SP - 1
EP - 4
PB - Science Publishing Group
SN - 2578-9511
UR - https://doi.org/10.11648/j.ijcocr.20200501.11
AB - A 52-years old woman was diagnosed with an invasive left-sided ductal breast cancer, G3 – staged as T2N0M0; Estrogen (ER) 3+, Progesterone (PR) +, Human epidermal growth factor receptor 2 (HER 2) negative, Ki67-11%. She underwent a radical mastectomy, followed by adjuvant chemotherapy and hormone treatment with Tamoxifen. A year later she was diagnosed with a colorectal cancer-low grade, G1; histological results of adenocarcinoma - T3N1M1 with liver metastases. After a biopsy, which revealed that the metastases are coming from the breast (ER+/HER 2 (-) Breast cancer - (GATA (3+)), she was restaged as T3N1M0. The patient started treatment with Ribociclib 600mg/d + Letrozole 2,5mg/d with a partial response of the disease after three months of treatment. Due to G3 neutropenia, the dose was adjusted to 400 mg/d. Last restaging: October 2019 – complete response and a good quality of life. This case approves that the CDK (cyclin-dependent kinase) 4/6 inhibitors are able to manage visceral metastases and to provide long-term survival without worsening the quality of life. Her disease is successfully managed with CDK4/6 inhibitor together with hormonal therapy, which proves the effect of the CDK 4/6 inhibitors in treatment not only to breast cancer. Six months after there are no signs of relapse of the colon cancer. Despite the stage of the second cancer – T3N1M0, the patient did not undergo adjuvant treatment for the colon cancer.
VL - 5
IS - 1
ER -

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Author Information

Janet Raycheva

Department of Medical Oncology, University Hospital “Sofiamed”, Sofia, Bulgaria
Teodora Karanikolova

Department of Medical Oncology, Hospital “Nadezhda”, Sofia, Bulgaria
Rossitza Krusteva

Department of Medical Oncology, Hospital “UniHospital”, Panagyurishte, Bulgaria
Margarita Taushanova-Hadjieva

Department of Medical Oncology, University Hospital “Sofiamed”, Sofia, Bulgaria

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APA Style

Janet Raycheva, Teodora Karanikolova, Rossitza Krusteva, Margarita Taushanova-Hadjieva. (2020). Efficacy of CDK4/6 Inhibitor in Treatment of Metastatic Breast Cancer and Colon Cancer. International Journal of Clinical Oncology and Cancer Research, 5(1), 1-4. https://doi.org/10.11648/j.ijcocr.20200501.11

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ACS Style

Janet Raycheva; Teodora Karanikolova; Rossitza Krusteva; Margarita Taushanova-Hadjieva. Efficacy of CDK4/6 Inhibitor in Treatment of Metastatic Breast Cancer and Colon Cancer. Int. J. Clin. Oncol. Cancer Res. 2020, 5(1), 1-4. doi: 10.11648/j.ijcocr.20200501.11

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AMA Style

Janet Raycheva, Teodora Karanikolova, Rossitza Krusteva, Margarita Taushanova-Hadjieva. Efficacy of CDK4/6 Inhibitor in Treatment of Metastatic Breast Cancer and Colon Cancer. Int J Clin Oncol Cancer Res. 2020;5(1):1-4. doi: 10.11648/j.ijcocr.20200501.11

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@article{10.11648/j.ijcocr.20200501.11,
  author = {Janet Raycheva and Teodora Karanikolova and Rossitza Krusteva and Margarita Taushanova-Hadjieva},
  title = {Efficacy of CDK4/6 Inhibitor in Treatment of Metastatic Breast Cancer and Colon Cancer},
  journal = {International Journal of Clinical Oncology and Cancer Research},
  volume = {5},
  number = {1},
  pages = {1-4},
  doi = {10.11648/j.ijcocr.20200501.11},
  url = {https://doi.org/10.11648/j.ijcocr.20200501.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20200501.11},
  abstract = {A 52-years old woman was diagnosed with an invasive left-sided ductal breast cancer, G3 – staged as T2N0M0; Estrogen (ER) 3+, Progesterone (PR) +, Human epidermal growth factor receptor 2 (HER 2) negative, Ki67-11%. She underwent a radical mastectomy, followed by adjuvant chemotherapy and hormone treatment with Tamoxifen. A year later she was diagnosed with a colorectal cancer-low grade, G1; histological results of adenocarcinoma - T3N1M1 with liver metastases. After a biopsy, which revealed that the metastases are coming from the breast (ER+/HER 2 (-) Breast cancer - (GATA (3+)), she was restaged as T3N1M0. The patient started treatment with Ribociclib 600mg/d + Letrozole 2,5mg/d with a partial response of the disease after three months of treatment. Due to G3 neutropenia, the dose was adjusted to 400 mg/d. Last restaging: October 2019 – complete response and a good quality of life. This case approves that the CDK (cyclin-dependent kinase) 4/6 inhibitors are able to manage visceral metastases and to provide long-term survival without worsening the quality of life. Her disease is successfully managed with CDK4/6 inhibitor together with hormonal therapy, which proves the effect of the CDK 4/6 inhibitors in treatment not only to breast cancer. Six months after there are no signs of relapse of the colon cancer. Despite the stage of the second cancer – T3N1M0, the patient did not undergo adjuvant treatment for the colon cancer.},
 year = {2020}
}

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