{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T16:09:42Z","timestamp":1773850182431,"version":"3.50.1"},"reference-count":24,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Oncol"],"abstract":"<jats:p>&lt;p&gt;Background: Hormone receptor-positive breast cancer is the most common subtype, accounting for approximately two-thirds of all breast cancer cases. In the metastatic setting, first-line treatment is comprised of endocrine therapy and a cyclin-dependent kinase 4 and 6 inhibitor. Ribociclib is the most used agent and has the highest risk of hepatotoxicity among the three currently available cyclin-dependent kinase 4 and 6 inhibitors. Case Presentation: We present a case of a 59-year-old postmenopausal female with metastatic hormone receptor-positive breast cancer who started treatment with fulvestrant and ribociclib after progression on anastrozole. After the third cycle, she developed grade 3 transaminitis. Ribociclib was held, and after no improvement in 28 days, she was treated with a 6-day course of prednisone 1 mg\/kg, with significant improvement in her liver enzymes. Rechallenge with a lower dose of ribociclib (200 mg) was attempted; however, she again developed grade 3 transaminitis. This again required treatment with a short course of corticosteroids. Following normalization of her liver enzymes, she was rechallenged with abemaciclib with no recurrent hepatotoxicity. Conclusion: Ribociclib hepatotoxicity can be successfully treated with withdrawal of the medication and a short course of corticosteroids if liver enzymes do not improve following a 28-day withdrawal, highlighting a potential immune-mediated mechanism. Additionally, rechallenge with another cyclin-dependent kinase 4 and 6 inhibitor is a safe and effective strategy that should be considered. &lt;\/p&gt;<\/jats:p>","DOI":"10.1159\/000549179","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T17:01:03Z","timestamp":1761584463000},"page":"1517-1524","source":"Crossref","is-referenced-by-count":2,"title":["Ribociclib-Induced Hepatitis: A Case Report of Possible Autoimmune Hepatotoxicity"],"prefix":"10.1159","volume":"18","author":[{"given":"Jennifer","family":"Leigh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan","family":"Rivera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam","family":"Alsulaiman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Brezden-Masley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1038\/s41417-024-00747-x"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.75.6155"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1607303"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-21-3032"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2114663"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.01994"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2305488"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30165-3"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1177\/10781552231154009"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1097\/CAD.0000000000000845"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2024.101098"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2019.01235"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1080\/14737140.2021.1852934"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.71817"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1256783"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2020.1853228"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1177\/10781552211027931"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.3390\/medicina59040696"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1080\/1120009X.2024.2433368"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.04.033"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2017.09.011"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1038\/nrc2602"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21176400"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2020.10.007"}],"container-title":["Case Reports in Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000549179","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T09:13:32Z","timestamp":1765358012000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000549179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,23]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000549179","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.30424891","asserted-by":"subject"}]},"ISSN":["1662-6575"],"issn-type":[{"value":"1662-6575","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,23]]}}}