Maka Vinayak V, Krishnaswamy Uma Maheshwari, Anil Kumar N, Chitrapur Rohith, Kilara Nalini
Department of Medical Oncology , M. S. Ramaiah Medical College , MSRIT Post, Bangalore 560054 , India.
Department of Chest Medicine , M. S. Ramaiah Medical College , MSRIT Post, Bangalore 560054 , India.
Oxf Med Case Reports. 2014 Apr 8;2014(1):11-2. doi: 10.1093/omcr/omu004. eCollection 2014 Apr.
Crizotinib, an orally active multi-targeted small-molecule anaplastic lymphoma kinase (ALK) inhibitor, is an effective treatment modality for advanced ALK-positive non-small-cell lung cancer (NSCLC). Most drug-related adverse events are mild to moderate; however, some patients may develop acute interstitial lung disease (ILD) which is sometimes fatal. We present a case of crizotinib-associated ILD in a 47-year-old woman treated with crizotinib for metastatic adenocarcinoma of the lung. The patient presented with acute breathlessness and hypoxaemia in the second month of crizotinib therapy; radiological and histopathological work-up was suggestive of acute interstitial pneumonia. The patient improved clinically with corticosteroid therapy and was successfully re-challenged with crizotinib. In conclusion, while treating NSCLC patients with crizotinib, it is important to promptly investigate and treat any new-onset respiratory symptoms, as the latter could represent an adverse effect related to therapy. Prompt discontinuation of the offending drug and initiation of corticosteroid therapy may prevent adverse outcomes.
克唑替尼是一种口服活性多靶点小分子间变性淋巴瘤激酶（ALK）抑制剂，是晚期ALK阳性非小细胞肺癌（NSCLC）的有效治疗方式。大多数与药物相关的不良事件为轻度至中度；然而，一些患者可能会发生急性间质性肺病（ILD），有时甚至会致命。我们报告一例47岁女性患者，她因肺转移性腺癌接受克唑替尼治疗，出现了克唑替尼相关的ILD。该患者在克唑替尼治疗的第二个月出现急性呼吸困难和低氧血症；影像学和组织病理学检查提示急性间质性肺炎。患者经皮质类固醇治疗后临床症状改善，并成功再次接受克唑替尼治疗。总之，在用克唑替尼治疗NSCLC患者时，及时调查和治疗任何新发的呼吸道症状很重要，因为后者可能代表与治疗相关的不良反应。及时停用致病药物并开始皮质类固醇治疗可能会预防不良后果。
