Effect of adenosine triphosphate on ribociclib-induced skin toxicity in rats

AKBAŞ, Nergis; Akbaş, Emin Murat; Süleyman, Zeynep; Çiçek, Betül; Ağgül, Ahmet Gökhan; Mokhtare, Behzad; Süleyman, Halis

doi:10.1080/15569527.2023.2166524

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…Both staining methods revealed a reduced melanocyte number and the presence of melanin in the dermis. Besides, another report revealed the effect of ribociclib-induced pyknosis in keratinocytes ( 17 ); we also found dyskeratotic cells in the epidermis in our case. Therefore, we speculated that ribociclib-related dyschromia resulted from the uneven distribution of melanin and a decreased number of melanocytes, which are caused by impaired keratinocytes and melanocytes in the basal layer zone.…”

Section: Discussionsupporting

confidence: 82%

Case Report: Ribociclib-induced phototoxicity presented as dyschromia with subsequent bullae formation

Jhan,

Wang,

Chu

et al. 2023

Front. Oncol.

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Ribociclib, a cyclin-dependent kinase 4/6 inhibitor, is a novel targeted therapy for advanced-stage breast cancer. Although ribociclib-induced cutaneous side effects have been previously noted, they have not been well documented. Herein, we present a case of ribociclib-induced phototoxicity, which manifested as dyschromia over sun-exposed forearms and neck initially and as bullae formation subsequently. A 71-year-old woman with metastatic breast cancer developed dyschromia after daily treatment with ribociclib (600 mg) for 7 months. Skin biopsy of the pigmented lesion revealed interface dermatitis with melanin incontinence and dyskeratotic cells and ballooning keratinocytes with loss of melanocytes in the basal layer. Further, clefting at the basal layer of epidermis was noted in a more hyperpigmented field. Fontana–Masson staining revealed melanophages in the dermis. Human Melanoma Black-45 staining revealed decreased melanocyte numbers in the epidermis above the cleft. Immunohistochemical analyses revealed activated CD1a+ epidermal Langerhans cells and infiltrating CD4+ and CD8+ T cells in the epidermis and dermis, thereby indicating type IV hypersensitivity that was associated with damage to keratinocytes and melanocytes. To prevent progression of bullous dermatitis, we advised the patient to discontinue ribociclib and prescribed oral and topical prednisolone. Due to the risk of phototoxicity, we educated the patient on sun-protection strategies. The patient’s skin lesions subsided during the 2 months of treatment. Phototoxicity with dyschromia is a rare but significant ribociclib-induced cutaneous side effect. Early diagnosis, rapid ribociclib withdrawal, protection from sunlight, and prompt treatment are critical for preventing subsequent severe bullous dermatosis.

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Section: Discussionsupporting

confidence: 82%

Case Report: Ribociclib-induced phototoxicity presented as dyschromia with subsequent bullae formation

Jhan,

Wang,

Chu

et al. 2023

Front. Oncol.

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“…The study speculated that ATP may be useful in the treatment of ribociclib-induced skin damage, but this evidence needs to be validated in humans. 32 …”

Section: Discussionmentioning

confidence: 99%

Ribociclib-Induced Cutaneous Adverse Events in Metastatic HR+/HER2− Breast Cancer: Incidence, Multidisciplinary Management, and Prognostic Implication

Borroni,

Bartolini,

Gaudio

et al. 2024

The Oncologist

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Background Ribociclib is approved for hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2−) advanced breast cancer (ABC) treatment, in combination with endocrine therapy. Hematological, hepatic, and cardiac adverse events (AEs) emerged from pivotal trials, but little is known about cutaneous adverse events (CAEs). Patients and Methods We report data from a retrospective cohort study of all patients with HR+/HER2− ABC treated with ribociclib at Humanitas Cancer Center between June 2017 and December 2022. We recorded clinical-pathological data, the incidence, and treatment of ribociclib-related CAEs. These were evaluated according to the NCI-CTCAE v5.0 classification. Progression-free survival (PFS) was estimated by Kaplan-Meier method and the log-rank test was used to analyze differences between groups. Results Thirteen of 91 patients (14.3%) experienced treatment-related CAEs (mean time to the occurrence: 3.9 months). The most frequent CAEs were eczematous dermatitis (53.8%) and maculo-papular reaction (15.4%). Itch was reported by all 13 patients. The grade was G3 in 8 cases, G2 in 4, and G1 in 1. An integrated approach based on ribociclib dose modulation and dermatological interventions (oral antihistamine, moisturized cream, topical, and/or systemic steroids) could prevent ribociclib discontinuation in most patients. At a median follow-up of 20 months, the median PFS was 13 months (range, 1-66) with a better PFS curves for patients experiencing CAEs (P = .04). Conclusion We mapped frequency and types of ribociclib-induced CAEs. An interdisciplinary management of CAEs incorporated into routine care may reduce the rate of drug discontinuation thus potentially contributing to better long-term outcomes.

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Comparative Investigation of the Effects of Adenosine Triphosphate and Agomelatine Against Acrolein-Induced Oxidative and Inflammatory Lung Injury in Rats

Unver,

Suleyman,

Mammadov

et al. 2024

International J. of Pharmacology

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Effect of adenosine triphosphate on ribociclib-induced skin toxicity in rats

Cited by 3 publications

References 27 publications

Case Report: Ribociclib-induced phototoxicity presented as dyschromia with subsequent bullae formation

Case Report: Ribociclib-induced phototoxicity presented as dyschromia with subsequent bullae formation

Ribociclib-Induced Cutaneous Adverse Events in Metastatic HR+/HER2− Breast Cancer: Incidence, Multidisciplinary Management, and Prognostic Implication

Comparative Investigation of the Effects of Adenosine Triphosphate and Agomelatine Against Acrolein-Induced Oxidative and Inflammatory Lung Injury in Rats

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