Case series of metastatic breast cancer patients with visceral crisis treated with CDK4/6 inhibitors

Abstract

There is an ongoing clinical dilemma of how best to treat patients who present themselves with visceral crisis. The time needed to undo the state of visceral crisis is the most relevant outcome for this patient group. We describe four patients treated with CDK4/6 inhibitor plus endocrine therapy for HR+/HER2- metastatic breast cancer who presented themselves with a visceral crisis. Two of them are male and three of them had synchronous metastatic breast cancer. Two patients had lymphangitis carcinomatosis of the lungs, one extensive disease of the eye and one of the liver. Time to first clinical response was observed within a few weeks in three patients. For one patient a switch to chemotherapy was needed. These cases show that treatment with CDK4/6 inhibitors can achieve a rapid response in patients experiencing visceral crisis. We conclude that chemotherapy is not the sole possibility in visceral crisis, and that CDK4/6 inhibitors can be considered as well.

Keywords:

• Visceral crisis
• visceral disease
• breast cancer
• metastases
• chemotherapy
• CDK4/6 inhibitors

Authors’ contributions

Conceptualization: VTH and WD; Resources; VTH, WD and MK; Investigation and original draft: MM and MV; All authors read and approved the final manuscript.

Disclosure statement

MM reports institutional grants from Gilead. SG reports institutional grants from Novartis BV, Roche, Pfizer, Eli Lilly, Daiichi Sankyo, Astra-Zeneca and Gilead, and personal fees from Astra-Zeneca. VTH reports institutional grants and personal fees from Roche, Novartis, Pfizer, and Eli Lilly, and institutional grants from AstraZeneca, Daiichi Sankyo and Gilead. All remaining authors have declared no conflicts of interest.

Data availability statement

Data sharing is not applicable to this case report.