Gou Xiaoli, Yuan Cheng, Bai Yuju, Shi Lei, Xing Shiyun, Ma Hu
Department of Oncology, The Affiliated Hospital of Zunyi Medical University, Zunyi, China.
The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University), Zunyi, China.
Ann Palliat Med. 2021 Apr;10(4):4932-4937. doi: 10.21037/apm-19-420. Epub 2020 Sep 22.
Crizotinib is the first-line drug for non-small cell lung cancer (NSCLC) patients who display anaplastic lymphoma kinase (ALK) rearrangement. With 60% overall response rate, crizotinib significantly prolongs median progression-free survival (ranged 8-10 months) of ALK rearrangement NSCLC patients. However, there are some adverse events from crizotinib, including diarrhea, weakness and nausea. Here, we describe a 47 years old woman with ALK-rearranged NSCLC who developed interstitial pneumonia (IP) induced by crizotinib. A female patient was diagnosed as the left lower lobe adenocarcinoma stage IV (T4N2M1, pleural metastasis) via lung biopsy and was detected wild-type EGFR and 18% ALK gene rearrangement from paraffin section. However, after going through 7 cycles of chemotherapy, she rejected chemotherapy because side effect and still experienced progression of the disease. Subsequently, crizotinib was prescribed as a targeted therapy. After 32 days, visible reduction in size was observed on the pulmonary mass and metastases found in brain and liver, but the patient presented drug-induced level 4 interstitial pneumonia. In a nutshell, the curative effect of crizotinib is worthy of note, but clinicians should also weigh the advantages and disadvantages, prior its usage.
克唑替尼是用于治疗间变性淋巴瘤激酶（ALK）重排的非小细胞肺癌（NSCLC）患者的一线药物。克唑替尼的总体缓解率为60%，可显著延长ALK重排的NSCLC患者的中位无进展生存期（8 - 10个月）。然而，克唑替尼存在一些不良事件，包括腹泻、乏力和恶心。在此，我们描述了一名47岁的ALK重排NSCLC女性患者，其因克唑替尼诱发了间质性肺炎（IP）。一名女性患者经肺活检被诊断为左肺下叶腺癌IV期（T4N2M1，胸膜转移），石蜡切片检测显示为野生型EGFR且ALK基因重排率为18%。然而，在经历7个周期的化疗后，她因副作用拒绝化疗，且疾病仍有进展。随后，给予克唑替尼作为靶向治疗。32天后，肺部肿块以及脑和肝转移灶的大小明显缩小，但患者出现了药物性4级间质性肺炎。简而言之，克唑替尼的疗效值得关注，但临床医生在使用前也应权衡其利弊。
