Kimura Tatsuo, Sowa-Osako Junko, Nakai Toshiyuki, Ohyama Ayako, Kawaguchi Tomoya, Tsuruta Daisuke, Ohsawa Masahiko, Hirata Kazuto
Department of Premier Preventive Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan; Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Department of Dermatology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Case Rep Oncol. 2016 Dec 8;9(3):826-832. doi: 10.1159/000453314. eCollection 2016 Sep-Dec.
Alectinib is an oral drug developed for the treatment of patients with fusion gene encoding echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase ()-rearranged non-small cell lung cancer (NSCLC). Here, we present the case of a patient treated with alectinib who developed a hypersensitivity reaction with successful rechallenge treatment.
A 39-year-old woman who was a passive smoker was referred to Osaka City University Hospital for the evaluation of a skin event caused by treatment for NSCLC with the fusion gene . The skin reaction was observed on the anterior chest, upper arms, and ear auricles on day 11 of treatment with oral alectinib. The skin event presented as widely distributed erythematous macules that were confluent, indicating a severe and life-threatening form. The skin lesions started to resolve after the initiation of treatment with 40 mg prednisolone. After regrowth of the tumor, she received a rechallenge program for alectinib for 2 weeks; thereafter, alectinib treatment was successfully reinitiated.
To the best of our knowledge, we present the first case in which alectinib, which binds to the adenosine triphosphate site of , induced erythema multiforme. Moreover, successful readministration of alectinib through our rechallenge program has not been reported so far.
阿来替尼是一种口服药物，用于治疗棘皮动物微管相关蛋白样 4 - 间变性淋巴瘤激酶（ALK）融合基因重排的非小细胞肺癌（NSCLC）患者。在此，我们报告一例接受阿来替尼治疗的患者发生超敏反应且再次给药成功的病例。
一名 39 岁的女性，为被动吸烟者，因评估融合基因 NSCLC 治疗引起 的皮肤事件转诊至大阪市立大学医院。在口服阿来替尼治疗第 11 天时，前胸、上臂和耳廓出现皮肤反应。皮肤事件表现为广泛分布的融合性红斑丘疹，提示为严重且危及生命的形式。开始用 40mg 泼尼松龙治疗后，皮肤病变开始消退。肿瘤复发后，她接受了为期 2 周的阿来替尼再次给药方案；此后，成功重新开始阿来替尼治疗。
据我们所知，我们报告了首例阿来替尼（其与 ALK 的三磷酸腺苷位点结合）诱导多形红斑的病例。此外，迄今为止尚未报道通过我们的再次给药方案成功重新给予阿来替尼的情况。
