PDF(Pubmed)
Abstract：
Breast cancer is the second most common cancer amongst women in the United States following non-melanoma skin cancer. There were an estimated 276,480 new cases and 42,170 deaths in 2020. The lifetime risk for developing breast cancer in females is about 13%. In the United States this year approximately 284,200 people out of which 281,550 women and 2,650 men, will be diagnosed with invasive breast cancer. In recent years, treatment options with novel mechanisms have emerged. Cyclin dependent kinase (CDK) 4/6 inhibitors, namely palbociclib, ribociclib and abemaciclib, are relatively new targeted therapies for treating breast cancers express estrogen receptors (ER) and/or progesterone receptors (PR). CDKs are important regulatory enzymes in cell cycle transitions and cell division. Selective inhibition of CDK4/6 causes cell cycle to arrest in the G1 phase, resulting in reduced cell viability and tumor response. Abemaciclib is the only one approved as monotherapy. Palbociclib and ribociclib must be used as adjunctive therapy to endocrine therapy such as tamoxifen, aromatase inhibitors or fulvestrant. Common side effects include neutropenia, thrombocytopenia, fatigue, nausea, and vomiting. A black box warning for all CDK inhibitors is a rare but possibly fatal severe inflammation of the lungs, called pneumonitis. We present a fatal case of severe pneumonitis with superimposed fungal respiratory infection in the setting of hypogammaglobulinemia in a 65-year-old female with metastatic ER and PR positive, human epidermal growth factor receptor 2 (HER-2) negative breast cancer who received abemaciclib.
摘要：
乳腺癌是仅次于非黑色素瘤皮肤癌的美国女性中第二常见的癌症。2020年估计有276,480例新病例和42,170例死亡。女性患乳腺癌的终生风险约为13％。在美国，今年大约有284,200人，其中有281,550名女性和2,650名男性，会被诊断为浸润性乳腺癌.近年来,具有新机制的治疗选择已经出现。细胞周期蛋白依赖性激酶（CDK）4/6抑制剂，即palbociclib,ribociclib和abemaciclib，是用于治疗表达雌激素受体(ER)和/或孕激素受体(PR)的乳腺癌的相对较新的靶向疗法。CDK是细胞周期转换和细胞分裂中的重要调控酶。CDK4/6的选择性抑制导致细胞周期停滞在G1期，导致细胞活力和肿瘤反应降低。Abemaciclib是唯一被批准为单一疗法的药物。Palbociclib和ribociclib必须用作内分泌治疗的辅助治疗，如他莫昔芬，芳香酶抑制剂或氟维司群。常见的副作用包括中性粒细胞减少,血小板减少症,疲劳,恶心,和呕吐。所有CDK抑制剂的黑匣子警告是一种罕见但可能致命的肺部严重炎症，叫做肺炎.我们介绍了一名65岁的女性转移性ER和PR阳性，在低丙种球蛋白血症的情况下，严重肺炎合并真菌呼吸道感染的致命病例。接受abemaciclib治疗的人表皮生长因子受体2（HER-2）阴性乳腺癌。
