Successful re-introduction of alectinib after inducing interstitial lung disease in a patient with lung cancer

J Oncol Pharm Pract. 2019 Sep;25(6):1531-1533. doi: 10.1177/1078155218820580. Epub 2018 Dec 20.

Abstract

Alectinib is a member of the family of anaplastic lymphoma kinase inhibitors. This agent is effective in the treatment of advanced anaplastic lymphoma kinase-positive non-small cell lung cancer and has excellent blood-brain barrier penetrability. It is generally well tolerated; however, significant toxicities such as interstitial lung disease have been reported. We present herein an instance of interstitial lung disease four weeks into alectinib treatment. Alectinib was held, and the patient showed clinical and radiographic improvement of her interstitial lung disease. Alectinib was then resumed at half dosage without further complications. Prompt recognition of adverse reactions to this targeted agent is paramount. Cessation of therapy may be needed on a case-to-case basis. However, as our case highlights, safe re-introduction of alectinib can be accomplished in some cases.

Keywords: Alectinib; anaplastic lymphoma kinase inhibitor; interstitial lung disease; lung cancer.

Publication types

  • Case Reports

MeSH terms

  • Carbazoles / adverse effects
  • Carbazoles / therapeutic use*
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Female
  • Humans
  • Lung Diseases, Interstitial / chemically induced*
  • Lung Diseases, Interstitial / diagnostic imaging
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / drug therapy*
  • Middle Aged
  • Piperidines / adverse effects
  • Piperidines / therapeutic use*
  • Protein Kinase Inhibitors / adverse effects
  • Protein Kinase Inhibitors / therapeutic use*

Substances

  • Carbazoles
  • Piperidines
  • Protein Kinase Inhibitors
  • alectinib