DOI: 10.12890/2025_006043
Delayed-onset vitiligo in metastatic HR+/HER2– breast cancer during long-term ribociclib therapy.
Authors
elias.tayar@hcahealthcare.com
Keywords
Breast cancer, cyclin-dependent kinase 4/6 inhibitors, ribociclib, vitiligoAbstract
Vitiligo is a rare cutaneous adverse event associated with cyclin-dependent kinase 4/6 (CDK4/6) inhibitors. We report a 56-year-old woman with de novo metastatic HR+/HER2– breast cancer who developed vitiligo several years into long-term ribociclib therapy. She was initially treated with palbociclib plus letrozole and later transitioned to a reduced dose of ribociclib due to cytopenias and coverage limitations. After 3 years on ribociclib, she developed asymptomatic hypopigmented patches on her hands and face. Dermatologic evaluation confirmed vitiligo. Treatment was conservative with topical corticosteroids, and ribociclib was continued without interruption. Her metastatic disease remained stable with durable oncologic control. This case highlights delayed-onset vitiligo as an uncommon immune-mediated toxicity during prolonged CDK4/6 inhibitor therapy and demonstrates that such lesions do not necessitate discontinuing effective cancer treatment.
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