Successful treatment with alectinib after crizotinib-induced interstitial lung disease

Lung Cancer. 2015 Dec;90(3):610-3. doi: 10.1016/j.lungcan.2015.09.019. Epub 2015 Sep 25.

Abstract

We herein report a case of a 46-year-old woman with anaplastic lymphoma kinase (ALK)-rearranged stage IV lung adenocarcinoma who received the ALK inhibitor crizotinib as second-line therapy. On the 47th day following crizotinib initiation, a chest computed tomography scan revealed ground-glass opacities with a clinical manifestation of desaturation, although a partial response to treatment was detected. The diagnosis of crizotinib-induced interstitial lung disease (ILD) was confirmed, and crizotinib was discontinued, followed by the initiation of corticosteroid therapy. After improvement of ILD with corticosteroid therapy, alectinib was administered as salvage therapy, resulting in tumor shrinkage without any recurrence of ILD. To the best of our knowledge, this is the first report of successful alectinib treatment following crizotinib-induced ILD. Our results indicate that alectinib could be a promising alternative treatment option in patients with crizotinib-induced ILD.

Keywords: Alectinib; Crizotinib; Drug induced interstitial lung disease; Molecular target drug.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / complications
  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / drug therapy
  • Adenocarcinoma of Lung
  • Antineoplastic Agents / adverse effects*
  • Carbazoles / therapeutic use*
  • Crizotinib
  • Female
  • Humans
  • Lung Diseases, Interstitial / diagnosis
  • Lung Diseases, Interstitial / drug therapy*
  • Lung Diseases, Interstitial / etiology*
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / drug therapy
  • Middle Aged
  • Piperidines / therapeutic use*
  • Protein Kinase Inhibitors / therapeutic use*
  • Pyrazoles / adverse effects*
  • Pyrazoles / therapeutic use
  • Pyridines / adverse effects*
  • Pyridines / therapeutic use
  • Radiography, Thoracic
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Carbazoles
  • Piperidines
  • Protein Kinase Inhibitors
  • Pyrazoles
  • Pyridines
  • Crizotinib
  • alectinib