Sakuma Ikki, Nagano Hidekazu, Yoshino Ichiro, Yokote Koutaro, Tanaka Tomoaki
Department of Clinical Cell Biology & Medicine, Chiba University Graduate School of Medicine, Japan.
Division of Endocrinology & Metabolism, Chiba University Hospital, Japan.
Intern Med. 2019 Mar 15;58(6):817-820. doi: 10.2169/internalmedicine.1870-18. Epub 2018 Nov 19.
We herein report a 75-year-old woman with insulin-treated diabetes and metastatic anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer who received ceritinib, a second-generation ALK inhibitor, and achieved dramatic tumor reduction. However, her fasting blood glucose increased, particularly markedly in the first two weeks after ceritinib administration, and did not normalize even increasing the total insulin dose. After discontinuing ceritinib, her glucose levels rapidly reduced. Ceritinib can aggravate hyperglycemia in patients with diabetes who lack compensatory insulin secretion, due to its inhibitory effects on the insulin receptor. Careful monitoring for ceritinib-induced hyperglycemia should be performed, especially in the first two weeks after ceritinib administration.
我们在此报告一名75岁女性，患有胰岛素治疗的糖尿病和转移性间变性淋巴瘤激酶（ALK）重排的非小细胞肺癌，接受了第二代ALK抑制剂色瑞替尼治疗，肿瘤显著缩小。然而，她的空腹血糖升高，尤其是在服用色瑞替尼后的前两周明显升高，即使增加胰岛素总剂量也未恢复正常。停用色瑞替尼后，她的血糖水平迅速下降。由于色瑞替尼对胰岛素受体的抑制作用，它可加重缺乏代偿性胰岛素分泌的糖尿病患者的高血糖。应密切监测色瑞替尼引起的高血糖，尤其是在服用色瑞替尼后的前两周。
