Fatal drug-induced liver injury in the setting of abemaciclib therapy for metastatic breast cancer.
Ranjini Vengilote, Syed Usman Ehsanullah, Mehul Patel
✦ AI-curated · Sources linked
Case in brief
A Hispanic woman in her mid-60s with metastatic ER+/HER2- breast cancer developed severe mixed hepatocellular-cholestatic injury one month after starting abemaciclib with letrozole. She presented with jaundice, pruritus, and dark urine, with lab results showing significantly elevated bilirubin and liver enzymes. Despite initial improvement after drug withdrawal and steroid treatment, her condition deteriorated, leading to liver failure and death.
Diagnostic / clinical pearl
Clinicians should be vigilant for signs of liver injury in patients receiving abemaciclib, particularly in those over 65 years or with fatty liver disease, as early recognition is crucial for management.
Why it matters
This case underscores the importance of patient education regarding liver injury symptoms and the need for close monitoring of liver function in patients on abemaciclib therapy.