I have just completed 3rd cycle of Ribociclib (kisquali) and my liver function has gone off, it is my first line treatment along with letrezole and gorserelin injections, AST levels are currently at 690 after raising over the last couple of weeks, oncologist has told me I can no longer take it. Has this happened to anyone else and what was given in its place, she has said if liver function returns to normal within the next 6 months she will try me on a medication from the ‘same family’?! Any help much appreciated.
Thanks x
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RachH20
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Hi, yes this happened to me. I managed 3 months also, at the highest strength dosage, as a first line treatment together with Femara, Zodalex and Zometa. My liver enzymes began rising from the first course. By the Third they were more than 10 x above normal. I felt very run down and could not focus or concentrate at this time. I was taken off all meds to allow my liver to detox. My oncologist told me to drink a lot of water and in my case also recommended that I try to lose some weight. I was also told to avoid all other vitamins, supplements and over the counter meds….not even allowed paracetamol. I was closely monitored, having blood tests every few days to check that enzymes were dropping. It took about 5 weeks.In my case because my oncologist believed that Kisqali was working but I was over sensitive to it ….she ruled against trying reduced dosages and extended break week times and advised Ibrance instead. I’ve now taken about four courses of the highest dosage and my liver has been fine. Recent scans showed reduction of primary tumour (40% smaller) and improved bone density. So no harm done by having the drug free break.
There are 3 targeted therapy meds that are CDK 4/6 inhibitors: Kisqali, Ibrance and Verzenio . They all work in a similar way targeting a specific protein found in breast cancer. So your oncologist seems to have come to the same conclusion as mine and it sounds like they will prescribe either Ibrance or Verzenio.
You can find a lot of info on different types of available meds and therapies on “Cancer.net” under “breast cancer- metastatic : types of treatment”
Hope this helps….any other questions you have please feel free to contact me…
Yes I cut that out straight away from the day of diagnosis, stopped all supplements painkillers etc and trying my absolute best to eat clean and exercise. Hoping this is just a bump in the road. Xx
Awww thank you so much for replying! That is so helpful to hear, I think mine have been slowly increasing and at the end of each cycle I had started to become unwell just mild with things like a UTI feeling run down sore mouth etc but the last 2 weeks AST went from 85 to 180 to 300 to 700. Everything else ok, bloods, had ultrasound scan liver today he said best looking liver he had seen for a while so just got to be this med not suiting me. Literally feel so much better reading your reply! Xx
Everyone of us responds differently to the various meds. I've not had a problem with my liver function since starting Ribociclib 2 yes ago. My onc reduced my dosage early on in my treatment due to low neutrophils and severe fatigue. Been much better on lower dose. Hoping you continue to do well on whatever treatment they put you on next🥰x
Thanks for your reply, yes I must admit I hadn’t even considered treatment not being suitable due to these kind of side effects. Taken me by surprise, hoping that liver function returns and I can get trying something else xx
I had a similar reaction to Ribociclib. Liver elevation started after 4 cycles. Peaked at about 20x. Stopped all supplements and the Ribociclib. Off of Ribociclib for 3 months. Was very tired.
Almost back to normal. ONC doesn’t want to try another CDK4/6 due concerns about possible liver damage. I have a second opinion from another ONC that it would be ok to try Ibrance. There are several case studies about women with similar issues who rechallenged successfully on Ibrance.
Thanks for your reply, my oncologist said that as long as my liver returns to normal function within 6 months from stopping ribociclib I can try another she said within the ‘same family’ so I’m presuming she will try ibrance. Good job you got a second opinion, it’s hard enough to navigate all this without oncologist looking at all options.
So your liver function has taken 3 months to return to normal, mine was really high at 700 on Friday. More bloods tomorrow. I’m off everything other than prescribed letrezole and ad cal xx
My SGPT peaked at 1069 in January and is now 36. SGOT was 742 in Jan now 46. Ive read some people have taken prednisone to quickly lower the liver. My ONC and Gastroenterologist were confident it would resolve itself which it mostly has.
I’ve just restarted multivitamin and calcium supplements. Hoping to see at least one hepatologist to discuss the liver implications before pushing harder for the Ibrance.
Yeah so I sound similar to you, I’m just in hospital now getting it checked and they mentioned the steroids to bring it down so I will see what the dr says when my bloods are back. Xx
I hope it works for you, I think my liver had been rising slowly over the course and then jumped up after cycle 3, my oncologist said it will normally show between cycle 3-5. Best of luck with your treatment xx
Hiya, yes mine kept rising even when I was taken off ribociclib, it got to 1000 and they prescribed steroids and it’s come down to 98 but it’s taken 5 weeks. I’m seeing oncologist tomorrow who has said she is hoping to try me on another type but from the same family of drugs. Apparently this can happen between cycle 3-5, it’s very disappointing isn’t it. X
It is very disappointing 🙁. Is your cancer in your liver? Have you had a scan since being off ribo for 5 weeks?
hearing that yours kept increasing even after being taken off has me concerned. I didn’t think mine would be back to normal after a week, but I was hoping it would be heading in the right direction.
Again, at least hearing that this is possible, will make it easier if mine is up after todays bloodwork.
I was supposed to start on palbociclib but when my oncologist learned of ribo we changed the plan.
Is that the drug your oncologist is talking about switching you to?
Mine is bone mets spine and hip, yes it was rising alone for about 3 weeks and then it seemed to peak and at that point it was coming down slowly on its own but I was going on holiday for two weeks so the consultant at Christie’s said let’s be cautious and use steroids which is why I took a high dose for 2 weeks, 40mg a day.
My oncologist said she thinks I might have missed the boat for palbococlib which I’m not sure why that would be but that she was considering Abemaciclib which is one you take everyday without a break.
After very similar experience…explained above.I was put on Ibrance once enzymes reduced to normal. Have been closely monitored for liver issues but on 5th cycle now and all is good.
My mets were found in my liver through an annual scan on my kidney. Then through testing found a 1cm lump in my breast, 3 lymph nodes and 3 spots in my bones.
I had 8 rounds of IV chemo before starting ribo and letrozole but it’s still considered 1st line because the chemo was working. It’s not like it stopped fighting the cancer so we had to switch. It was part of the treatment plan from the start
From my experience for the first Three weeks whilst off all meds…waiting for the enzymes to drop…not much happened. There was a little drop, but nothing big. By the next week things got much better and once moving, dropped steadily every check. Hope things work out for you soon.Take care, Zoe x
Yeah so sounds like the same thing is happening to you.
I saw a different oncologist today and I asked about the ‘missed the boat’ with palbococlib because he said that’s what they are trying next. He said it’s funding!!! I was completely shocked, he said I have until June to get back on one of these drugs! I have never been told that before. I have to go for repeat bloods next Tuesday and then breast clinic 17th may where hopefully everything is back to normal.
If yours keeps rising it might be worth asking about steroids to get it down quicker because my usual oncologist told me a couple of weeks ago that it can take months to happen by itself.
Just out of curiosity, what scan does everyone have every three months? I started out with CT thorax but now have full body MRIs, my next is not until July. X
I hope you get approval for the palbo. It’s crazy that your other oncologist didn’t provide those details. The price of these drugs is out of this world, no matter how much money someone has.
I will definitely ask mine about steroids when I meet with her next week.
I get a neck to pelvis CT scan every three months.
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