Aminopyridines , Breast Neoplasms , Cardiac Conduction System Disease , Purines , Aminopyridines/adverse effects , Aminopyridines/therapeutic use , Breast Neoplasms/drug therapy , Breast Neoplasms/epidemiology , Cardiac Conduction System Disease/chemically induced , Cardiac Conduction System Disease/epidemiology , Clinical Trials, Phase III as Topic , Female , Humans , Neoplasm Metastasis , Purines/adverse effects , Purines/therapeutic use , Randomized Controlled Trials as Topic , Risk Factors
Docetaxel is an anti-microtubule agent and a highly effective treatment of locally advanced and metastatic breast cancer. There are several adverse effects associated with docetaxel, such as myelosuppression, peripheral neuropathy, fluid retention, and asthenia. One of the most well-known side-effects of this medication is mild to moderate myalgia. Here, we report a case of a 49-year-old female with stage 3 breast cancers who developed severe acute myositis following docetaxel use. The mechanism of docetaxel-induced myositis remains unclear; however, physicians still need to be aware of the possibility of this complication in patients with cancer and a history of exposure to this medication.
Antineoplastic Agents/adverse effects , Breast Neoplasms/drug therapy , Docetaxel/adverse effects , Myositis/chemically induced , Antineoplastic Agents/therapeutic use , Docetaxel/therapeutic use , Female , Humans , Middle Aged
PURPOSE: Approximately 70% of patients with metastatic breast cancer (MBC) are hormone receptor (HR)-positive. Recent studies have shown that CDK4/6 inhibitors (CDKI) improve survival in combination with ET in HR-positive, HER2-negative MBC. The risk of venous thromboembolism (VTE) is 3-4 times higher in patients with breast cancer (BC) than in patients without cancer. The risk is even higher in BC patients receiving ET and chemotherapy. The aim of the study was to determine the VTE risk of CDKIs plus ET versus ET alone in patients with HR-positive, HER2-negative MBC. METHODS: We performed a systematic review and meta-analysis to demonstrate the risk of VTE in patients with HR-positive HER2-negative MBC treated with combined CDKIs and ET versus ET alone. RESULTS: Eight randomized controlled trials (RCT) with a total of 4,557 patients were eligible. The study arms comprised of palbociclib or ribociclib or abemaciclib plus ET while the control arms utilized placebo plus ET. The VTE events were 56 (2%) in the CDKIs plus ET group compared to 10 (0.5%) in the control group. Pooled relative risk (RR) for VTE was 2.62 (95% CI 1.21-5.65; P = 0.01) and the risk difference (RD) was 0.01 (95% CI 0.00-0.03; P = 0.02). Over a median follow-up of up to 36 months, RR was 3.18 (95% CI 1.22-8.24; P = 0.02) and RD was 0.03 (95% CI 0.01-0.06, P = 0.008). CONCLUSIONS: Our meta-analyses demonstrated that the addition of CDKIs to ET in patients with HR-positive HER 2-negative MBC contribute to a higher incidence of VTE. Further trials are required to define the actual relation and definitive incidence of VTE with different CDKIs.
Antineoplastic Agents, Hormonal/adverse effects , Breast Neoplasms/drug therapy , Cyclin-Dependent Kinase 4/antagonists & inhibitors , Cyclin-Dependent Kinase 6/antagonists & inhibitors , Protein Kinase Inhibitors/adverse effects , Venous Thromboembolism/pathology , Breast Neoplasms/metabolism , Breast Neoplasms/pathology , Drug Therapy, Combination , Estrogen Receptor alpha/metabolism , Female , Humans , Neoplasm Metastasis , Randomized Controlled Trials as Topic , Receptor, ErbB-2/metabolism , Receptors, Progesterone/metabolism , Risk Factors , Venous Thromboembolism/chemically induced
