Fatigue, alopecia and stomatitis among patients with breast cancer receiving cyclin-dependent kinase 4 and 6 inhibitors: a systematic review and meta-analysis

Lasheen, Shaimaa; Shohdy, Kyrillus S.; Kassem, Loay; Abdel‐Rahman, Omar

doi:10.1080/14737140.2017.1355242

Cited by 31 publications

(25 citation statements)

References 19 publications

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“…This suggests that fatigue is quite common and other clinical factors, including the neurophysiological effects of the breast cancer itself, likely contribute to the experience of fatigue rather than the effects of chemotherapy alone. We found that an increase in fatigue was reported during the chemotherapy treatment period, which supported the study hypotheses and was consistent with prior reports of fatigue in the context of chemotherapy . A decrease in fatigue severity, which occurred for most women by 1‐year post‐chemotherapy indicates that chemotherapy did not produce long‐term exacerbation of fatigue beyond the levels experienced prior to chemotherapy.…”

Section: Discussionsupporting

confidence: 90%

Relationship of fatigue with cognitive performance in women with early‐stage breast cancer over 2 years

et al. 2019

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Objective: Fatigue and cognitive dysfunction are major concerns for women with early-stage breast cancer during treatment and into survivorship. However, interrelationships of these phenomena and their temporal patterns over time are not well documented, thus limiting the strategies for symptom management interventions. In this study, changes in fatigue across treatment phases and the relationship among fatigue severity and its functional impact with objective cognitive performance were examined.Methods: Participants (N = 75) were assessed at five time points beginning prior to chemotherapy to 24 months after initial chemotherapy. Fatigue severity and impact were measured on the Brief Fatigue Inventory. Central nervous system (CNS) VitalSigns was used to measure performance based cognitive testing. Temporal changes in fatigue were examined, as well as the relationship between fatigue and cognitive performance, at each time point using linear mixed effect models.Results: Severity of fatigue varied as a function of phase of treatment. Fatigue severity and its functional impact were moderate at baseline, increased significantly during chemotherapy, and returned to near baseline levels by 2 years. At each time point, fatigue severity and impact were significantly associated with diminished processing speed and complex attention performance. Conclusions:A strong association between fatigue and objective cognitive performance suggests that they are likely functionally related. That cognitive deficits were evident at baseline, whereas fatigue was more chemotherapy dependent, implicates that two symptoms share some common bases but may differ in underlying mechanisms and severity over time. This knowledge provides a basis for introducing strategies for tailored symptom management that vary over time.

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Section: Discussionsupporting

confidence: 90%

Relationship of fatigue with cognitive performance in women with early‐stage breast cancer over 2 years

et al. 2019

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“…GI adverse drug reactions are generally well controlled by standard antiemetic (e.g., metoclopramide, serotonin 5-HT3 antagonists), while the prophylactic administration of loperamide is recommended to prevent diarrhea in patient treated with abemaciclib [23]. Fatigue, alopecia and stomatitis have also been reported among patients treated with this class of drugs [24].…”

Section: Safetymentioning

confidence: 99%

“…TypeConditions Likelihood Comorbidities Hypothyroidism, hypothermia, extreme bradycardia, cardiac disorders, kidney failure, liver dysfunction, poorly controlled diabetes Torsade de pointes. References:[24,40,56,57].…”

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confidence: 99%

Drug-drug interactions in breast cancer patients treated with CDK4/6 inhibitors

Fogli

Curigliano

et al. 2019

Cancer Treatment Reviews

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CDK4/6 inhibitors are a new class of anticancer drugs used for the treatment of women with hormone receptorpositive, human epidermal growth factor receptor 2-negative advanced or metastatic breast cancer with disease progression following endocrine therapy. Polypharmacy is a well-known problem in advanced cancer causing potential drug-drug interactions (DDIs), which, in turn, may limit the therapeutic value of CDK4/6 inhibitors. Therefore, understanding the mechanisms underlying potential DDIs in patients taking CDK4/6 inhibitors may be useful in decision-making processes and represent an important step towards treatment personalization. The present review is aimed at describing the potential DDIs that might occur in breast cancer patients receiving CDK4/6 inhibitors based on direct evidence from the literature and mechanistic considerations tailored on specific class of drugs used in combination.

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“…Oral mucositis, specifically stomatitis characterized by aphthous ulcer, occurs in very few patients treated with cyclin-dependent kinase 4/6 inhibitors (CDK4/6) [50,51], used as first-or second-line treatment for hormone positive/HER2 negative metastatic breast cancer. However, this regimen promotes GIM rather than OM.…”

Section: Mucositis Pathogenesismentioning

confidence: 99%

Oral mucositis: the hidden side of cancer therapy

Pulito¹,

Cristaudo

Porta

et al. 2020

J Exp Clin Cancer Res

241

135

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Inflammation response of epithelial mucosa to chemo- radiotherapy cytotoxic effects leads to mucositis, a painful side effect of antineoplastic treatments. About 40% of the patients treated with chemotherapy develop mucositis; this percentage rises to about 90% for head and neck cancer patients (HNC) treated with both chemo- and radiotherapy. 19% of the latter will be hospitalized and will experience a delay in antineoplastic treatment for high-grade mucositis management, resulting in a reduction of the quality of life, a worse prognosis and an increase in patient management costs. Currently, several interventions and prevention guidelines are available, but their effectiveness is uncertain. This review comprehensively describes mucositis, debating the impact of standard chemo-radiotherapy and targeted therapy on mucositis development and pointing out the limits and the benefits of current mucositis treatment strategies and assessment guidelines. Moreover, the review critically examines the feasibility of the existing biomarkers to predict patient risk of developing oral mucositis and their role in early diagnosis. Despite the expression levels of some proteins involved in the inflammation response, such as TNF-α or IL-1β, partially correlate with mucositis process, their presence does not exclude others mucositis-independent inflammation events. This strongly suggests the need to discover biomarkers that specifically feature mucositis process development. Non-coding RNAs might hold this potential.

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Fatigue, alopecia and stomatitis among patients with breast cancer receiving cyclin-dependent kinase 4 and 6 inhibitors: a systematic review and meta-analysis

Abstract: CDK4/6 inhibitors were associated with an increased risk of fatigue, alopecia and stomatitis. Further studies with self-reported questionnaires may elucidate the impact of the increased risk of these selected adverse effects on the patients' quality of life.

Cited by 31 publications

References 19 publications

Relationship of fatigue with cognitive performance in women with early‐stage breast cancer over 2 years

Relationship of fatigue with cognitive performance in women with early‐stage breast cancer over 2 years

Drug-drug interactions in breast cancer patients treated with CDK4/6 inhibitors

Oral mucositis: the hidden side of cancer therapy

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