Alectinib-induced hemolytic anemia

J Oncol Pharm Pract. 2023 Jan 5;10781552221147840. doi: 10.1177/10781552221147840. Online ahead of print.


Introduction: Alectinib is an oral anaplastic lymphoma kinase tyrosine kinase inhibitor with central nervous system activity. It is currently approved and a preferred first-line option for those with anaplastic lymphoma kinase-positive non-small cell lung cancer. Alectinib has been shown to cause anemia, usually mild.

Case report: We report a case of alectinib-induced hemolytic anemia in a patient receiving alectinib as first-line treatment for anaplastic lymphoma kinase-positive non-small cell lung cancer.

Management and outcome: The patient's dose was reduced from 600 mg twice daily to 450 mg twice daily and further down to 300 mg twice daily and eventually discontinued. At that point, the hemoglobin normalized.

Discussion: Our case demonstrates objective evidence for hemolytic anemia induced by alectinib.

Keywords: Alectinib; ROS Proto-Oncogene 1 (ROS1); anaplastic lymphoma kinase; hemolytic anemia; non-small cell lung cancer.