Refractory diarrhea in a patient with metastatic breast cancer with ABCB1 polymorphism: A case report
Although abemaciclib is an essential therapy for breast cancer, approximately 80 % of patients develop diarrhea. Abemaciclib undergoes excretion by the P-glycoprotein encoded by ATP-binding cassette subfamily B member 1 (ABCB1) in the small intestine during absorption. The polymorphism of this gene...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-06-01
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| Series: | Current Problems in Cancer: Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666621925000195 |
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| author | Moeko Iida Yoshihiko Tasaki Akiko Kato Tomoya Yasujima Hiroaki Yuasa Yasuhiro Maeda Yoshihisa Mimura Kunihiro Odagiri Yuka Kimura Nanami Ito Yasuhiro Horita Yosuke Sugiyama Yuji Hotta Tatsuya Toyama Yoko Furukawa-Hibi |
| author_facet | Moeko Iida Yoshihiko Tasaki Akiko Kato Tomoya Yasujima Hiroaki Yuasa Yasuhiro Maeda Yoshihisa Mimura Kunihiro Odagiri Yuka Kimura Nanami Ito Yasuhiro Horita Yosuke Sugiyama Yuji Hotta Tatsuya Toyama Yoko Furukawa-Hibi |
| author_sort | Moeko Iida |
| collection | DOAJ |
| description | Although abemaciclib is an essential therapy for breast cancer, approximately 80 % of patients develop diarrhea. Abemaciclib undergoes excretion by the P-glycoprotein encoded by ATP-binding cassette subfamily B member 1 (ABCB1) in the small intestine during absorption. The polymorphism of this gene is associated with adverse effects such as pancytopenia. Therefore, we report a case of refractory diarrhea in which ABCB1 polymorphisms were investigated. A Japanese 44-year-old female was diagnosed with breast cancer (estrogen receptor positive, progesterone receptor positive, and human epidermal growth factor receptor 2-negative) accompanied with bone metastasis. Although the patient was initially treated with abemaciclib, letrozole (Femara), and leuprorelin, refractory diarrhea induced by abemaciclib occurred after six days of treatment. Serum abemaciclib concentrations were measured before and after the diarrhea alleviation and the ABCB1 (3435C>T, 1236T>C, and 2677G>T/A) polymorphisms involved in delayed abemaciclib excretion were examined. ABCB1 3435C>T polymorphism was also identified. The abemaciclib concentration prior to diarrhea alleviation was higher than the mean concentration in a large-scale clinical trial (current study; 326.7 ng/mL vs a large-scale clinical trial; 169–243 ng/mL). The patient discontinued abemaciclib as it was difficult for her to continue the dose (150 mg twice daily) because of the associated diarrhea, which was alleviated thereafter. The abemaciclib concentration after diarrhea alleviation was below the detection limit of 25.0 ng/mL. ABCB1 3435C>T polymorphism may be involved in the induction of refractory diarrhea by abemaciclib and may be an objective indicator for managing abemaciclib dosage. |
| format | Article |
| id | doaj-art-3bd3c572736745e88ee014aa49b3f9eb |
| institution | OA Journals |
| issn | 2666-6219 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Current Problems in Cancer: Case Reports |
| spelling | doaj-art-3bd3c572736745e88ee014aa49b3f9eb2025-08-20T02:26:44ZengElsevierCurrent Problems in Cancer: Case Reports2666-62192025-06-011810036710.1016/j.cpccr.2025.100367Refractory diarrhea in a patient with metastatic breast cancer with ABCB1 polymorphism: A case reportMoeko Iida0Yoshihiko Tasaki1Akiko Kato2Tomoya Yasujima3Hiroaki Yuasa4Yasuhiro Maeda5Yoshihisa Mimura6Kunihiro Odagiri7Yuka Kimura8Nanami Ito9Yasuhiro Horita10Yosuke Sugiyama11Yuji Hotta12Tatsuya Toyama13Yoko Furukawa-Hibi14Department of Clinical Pharmaceutics, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, JapanDepartment of Clinical Pharmaceutics, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, JapanDepartment of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, JapanDepartment of Biopharmaceutics, Nagoya City University Graduate School of Pharmaceutical Sciences, 1-3 Tanabedori, Mizuho-ku, Nagoya, Aichi 467-8603, JapanDepartment of Biopharmaceutics, Nagoya City University Graduate School of Pharmaceutical Sciences, 1-3 Tanabedori, Mizuho-ku, Nagoya, Aichi 467-8603, JapanOpen Facility Center, Fujita Health University, 98-1 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, JapanDepartment of Clinical Pharmaceutics, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, JapanDepartment of Clinical Pharmaceutics, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, JapanDepartment of Clinical Pharmaceutics, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, JapanDepartment of Clinical Pharmaceutics, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, JapanDepartment of Clinical Pharmaceutics, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, JapanDepartment of Clinical Pharmaceutics, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, JapanDepartment of Clinical Pharmaceutics, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, JapanDepartment of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, JapanDepartment of Clinical Pharmaceutics, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan; Corresponding author: Department of Clinical Pharmaceutics, Nagoya City University Graduate School of Medical Sciences, One Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.Although abemaciclib is an essential therapy for breast cancer, approximately 80 % of patients develop diarrhea. Abemaciclib undergoes excretion by the P-glycoprotein encoded by ATP-binding cassette subfamily B member 1 (ABCB1) in the small intestine during absorption. The polymorphism of this gene is associated with adverse effects such as pancytopenia. Therefore, we report a case of refractory diarrhea in which ABCB1 polymorphisms were investigated. A Japanese 44-year-old female was diagnosed with breast cancer (estrogen receptor positive, progesterone receptor positive, and human epidermal growth factor receptor 2-negative) accompanied with bone metastasis. Although the patient was initially treated with abemaciclib, letrozole (Femara), and leuprorelin, refractory diarrhea induced by abemaciclib occurred after six days of treatment. Serum abemaciclib concentrations were measured before and after the diarrhea alleviation and the ABCB1 (3435C>T, 1236T>C, and 2677G>T/A) polymorphisms involved in delayed abemaciclib excretion were examined. ABCB1 3435C>T polymorphism was also identified. The abemaciclib concentration prior to diarrhea alleviation was higher than the mean concentration in a large-scale clinical trial (current study; 326.7 ng/mL vs a large-scale clinical trial; 169–243 ng/mL). The patient discontinued abemaciclib as it was difficult for her to continue the dose (150 mg twice daily) because of the associated diarrhea, which was alleviated thereafter. The abemaciclib concentration after diarrhea alleviation was below the detection limit of 25.0 ng/mL. ABCB1 3435C>T polymorphism may be involved in the induction of refractory diarrhea by abemaciclib and may be an objective indicator for managing abemaciclib dosage.http://www.sciencedirect.com/science/article/pii/S2666621925000195AbemaciclibBreast cancerABCB1Case reportDiarrhea |
| spellingShingle | Moeko Iida Yoshihiko Tasaki Akiko Kato Tomoya Yasujima Hiroaki Yuasa Yasuhiro Maeda Yoshihisa Mimura Kunihiro Odagiri Yuka Kimura Nanami Ito Yasuhiro Horita Yosuke Sugiyama Yuji Hotta Tatsuya Toyama Yoko Furukawa-Hibi Refractory diarrhea in a patient with metastatic breast cancer with ABCB1 polymorphism: A case report Current Problems in Cancer: Case Reports Abemaciclib Breast cancer ABCB1 Case report Diarrhea |
| title | Refractory diarrhea in a patient with metastatic breast cancer with ABCB1 polymorphism: A case report |
| title_full | Refractory diarrhea in a patient with metastatic breast cancer with ABCB1 polymorphism: A case report |
| title_fullStr | Refractory diarrhea in a patient with metastatic breast cancer with ABCB1 polymorphism: A case report |
| title_full_unstemmed | Refractory diarrhea in a patient with metastatic breast cancer with ABCB1 polymorphism: A case report |
| title_short | Refractory diarrhea in a patient with metastatic breast cancer with ABCB1 polymorphism: A case report |
| title_sort | refractory diarrhea in a patient with metastatic breast cancer with abcb1 polymorphism a case report |
| topic | Abemaciclib Breast cancer ABCB1 Case report Diarrhea |
| url | http://www.sciencedirect.com/science/article/pii/S2666621925000195 |
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