{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T18:57:07Z","timestamp":1779217027405,"version":"3.51.4"},"reference-count":12,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":113,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Oncological Medicine"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Ribociclib adds progression\u2010free survival and overall survival benefit in combination with endocrine therapy for first\u2010line treatment of advanced HR+ HER2\u2212 breast cancer; however, it comes with a risk of hepatotoxicity. There is guidance for monitoring liver function and holding the medication if hepatotoxicity arises. However, there is minimal guidance for management if withholding the medication alone is insufficient. We present a case of a woman with de novo metastatic HR+ HER2\u2212 breast cancer who developed grade 2 AST and ALT elevation after two cycles of ribociclib and anastrozole, which progressed over several weeks to Grade 4 hepatotoxicity despite holding the medication. Extensive evaluation revealed drug\u2010induced liver injury from ribociclib as the cause. Ultimately, a long course of corticosteroids was initiated with remarkable response and resolution of transaminitis. An empiric trial of corticosteroids should be considered for patients with severe ongoing hepatotoxicity from CDK4\/6 inhibitors despite cessation of the drug.<\/jats:p>","DOI":"10.1155\/crom\/4222126","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T13:18:00Z","timestamp":1777036680000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mitigating Severe Ribociclib\u2010Hepatotoxicity With Corticosteroids"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6722-9258","authenticated-orcid":false,"given":"Julie","family":"Williamson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7319-5175","authenticated-orcid":false,"given":"Maria","family":"Pletneva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7965-5760","authenticated-orcid":false,"given":"Rebecca G.","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roma","family":"Bhatia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"e_1_2_8_1_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1607303"},{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.75.6155"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1903765"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(22)00694-5"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2305488"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2021.39.15_suppl.1072"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2024.1378090"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2024.101098"},{"key":"e_1_2_8_9_2","unstructured":"National Institute of Diabetes and Digestive and Kidney Diseases LiverTox: Clinical and Research Information on Drug-Induced Liver Injury: Ribociclib 2018 https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK548818\/."},{"key":"e_1_2_8_10_2","unstructured":"National Institute of Diabetes and Digestive and Kidney Diseases LiverTox: Clinical and Research Information on Drug-Induced Liver Injury: Anastrazole 2017 https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK548189\/."},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.820724"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32689"}],"container-title":["Case Reports in Oncological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crom\/4222126","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crom\/4222126","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crom\/4222126","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T13:18:01Z","timestamp":1777036681000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crom\/4222126"}},"subtitle":[],"editor":[{"given":"Lipi","family":"Buch","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/crom\/4222126"],"URL":"https:\/\/doi.org\/10.1155\/crom\/4222126","archive":["Portico"],"relation":{},"ISSN":["2090-6706","2090-6714"],"issn-type":[{"value":"2090-6706","type":"print"},{"value":"2090-6714","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-01-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"4222126"}}