How do you modify your adjuvant therapy course in a patient experiencing liver dysfunction within the first few months of starting CDK4/6i?
For a patient recently started on therapy who develops severe transaminitis (AST and ALT >10–15× ULN) which does not readily improve in first few weeks after drug discontinuation, would you still try to incorporate the same or alternate CDK 4/6i after eventual resolution? Or continue endocrine therapy alone?
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How would you manage a patient with high risk breast cancer who developed severe transaminitis during the initial months of adjuvant CDK4/6i therapy, once transminitis has resolved?
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1 Answer
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Medical Oncology · Baylor College of Medicine
Answered on
We will adhere to the CTCAE grading system. Most of these patients do well with dose reduction and interruption. If persistent grade 2/3, will likely change to an alternate CDK agent and evaluate whether it solves LFT issues.
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