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Successful treatment with alectinib after crizotinib-induced hepatitis in ALK-rearranged advanced lung cancer patient: a case report.
- Source :
-
BMC pulmonary medicine [BMC Pulm Med] 2021 Jan 28; Vol. 21 (1), pp. 43. Date of Electronic Publication: 2021 Jan 28. - Publication Year :
- 2021
-
Abstract
- Background: Besides the clinical benefit of crizotinib in ALK-rearranged metastatic non-small cell lung cancer (NSCLC), concerns about its hepatotoxicity have arisen. It is not clear whether this is a drug class side effect or if the use of other selective ALKs inhibitors is safe after this serious adverse event. While evidence from clinical trials is scarce, reports of treatment after crizotinib-induces hepatitis may add to clinical decision.<br />Case Presentation: Herein, we report a case of acute hepatitis induced by crizotinib in a 32-years-old female diagnosed with metastatic NSCLC, harboring the ALK-rearrangement. After 60 days of crizotinib therapy, the patient presented with acute hepatitis, diagnosed after investigation of non-specific symptoms, such as nausea and fatigue. Serum aspartate aminotransferase and alanine aminotransferase levels had increased from baseline to 3010 IU/L and 9145 IU/L, respectively. Total bilirubin increased up to 7.91 mg/dL, but she did not develop liver failure. After crizotinib discontinuation, a gradual hepatic function recovery occurred. Unfortunately, during the period without specific oncology treatment, her disease showed an unequivocal progression. Therefore, she started on alectinib with great response, and no liver function alteration recurred.<br />Conclusions: This case suggests that alectinib, even belonging to the same drug class, could be used as an alternative agent when crizotinib is the etiology of liver damage, but more robust evidence has awaited.
- Subjects :
- Adult
Bilirubin blood
Carcinoma, Non-Small-Cell Lung pathology
Female
Hepatitis drug therapy
Humans
Liver drug effects
Liver physiopathology
Lung Neoplasms pathology
Protein Kinase Inhibitors therapeutic use
Treatment Outcome
Carbazoles therapeutic use
Carcinoma, Non-Small-Cell Lung drug therapy
Crizotinib adverse effects
Hepatitis etiology
Lung Neoplasms drug therapy
Piperidines therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2466
- Volume :
- 21
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC pulmonary medicine
- Publication Type :
- Academic Journal
- Accession number :
- 33509141
- Full Text :
- https://doi.org/10.1186/s12890-020-01390-6