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Emerging Skin Toxicities in Patients with Breast Cancer Treated with New Cyclin-Dependent Kinase 4/6 Inhibitors: A Systematic Review

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Abstract

Three cyclin-dependent kinases 4/6, including palbociclib, ribociclib, and abemaciclib, have been approved for the treatment of patients with hormone receptor-positive and human epidermal growth factor receptor 2-negative advanced breast cancer. The objective of this study was to evaluate the occurrence and clinical spectrum of cutaneous adverse events in patients with breast cancer following therapy with cyclin-dependent kinase 4/6 inhibitors. A systematic literature search was performed in the PubMed, Cochrane, and EMBASE databases up to November 2020 to evaluate studies published from 2015 to 2020. Articles were selected by title, abstract, and full text as required. In addition, a manual search was performed from among the references of articles included. Forty-one articles were included with a total of 13 reported dermatologic reactions including alopecia, bullous skin rash, Stevens–Johnson syndrome, toxic epidermal necrolysis, radiation recall and radiation dermatitis, Henoch–Schonlein purpura, cutaneous leukocytoclastic vasculitis, subacute and chronic cutaneous lupus erythematosus, histiocytoid Sweet syndrome, vitiligo-like lesions, and erythema dyschromicum perstans. Skin toxicity is an important issue because it usually affects a patient’s quality of life and could lead to a discontinuation of therapies; therefore, it is of fundamental importance to recognize and adequately manage the adverse skin reactions associated with these types of drugs.

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Authors and Affiliations

  1. Unit of Dermatology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy

    Martina Silvestri, Luigi Bennardo & Steven Paul Nisticò

  2. Department of Dermatology, San Gallicano Dermatological Institute-IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy

    Antonio Cristaudo, Aldo Morrone, Claudia Messina, Maria Mariano & Norma Cameli

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  1. Martina Silvestri
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  2. Antonio Cristaudo
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  4. Claudia Messina
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Correspondence to Maria Mariano.

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No external funding was received for the conduct of this research or the preparation of this article.

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Martina Silvestri, Antonio Cristaudo, Aldo Morrone, Claudia Messina, Luigi Bennardo, Steven Paul Nisticò, Maria Mariano, and Norma Cameli have no conflicts of interest that are directly relevant to the content of this article.

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Authors’ contributions

MS: study design; conceptualization; methodology; writing original draft; databases strategy research and extraction of data. AC: conceptualization; supervision; data curation. AM: critical revision of the manuscript. CM: databases strategy research. LB: data curation; SPN: supervision, data curation. MM: conceptualization; methodology; data curation. NC: study design; conceptualization; methodology; supervision; data curation. All authors read and approved the final version.

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Silvestri, M., Cristaudo, A., Morrone, A. et al. Emerging Skin Toxicities in Patients with Breast Cancer Treated with New Cyclin-Dependent Kinase 4/6 Inhibitors: A Systematic Review. Drug Saf 44, 725–732 (2021). https://doi.org/10.1007/s40264-021-01071-1

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