Peng Ling, Xiao Kui, Cui Jian, Ye Xiang-Hua, Zhang Yong-Chang, Mao Li, Selvaggi Giovanni, Yen Jennifer, Stebbing Justin
Department of Pulmonary and Critical Care Medicine, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang Province, People's Republic of China.
Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, People's Republic of China.
Onco Targets Ther. 2021 May 25;14:3409-3415. doi: 10.2147/OTT.S310756. eCollection 2021.
Alectinib is approved for the treatment of advanced non-small-cell lung cancer (NSCLC) harboring ALK rearrangements. Although generally well tolerated, alectinib can cause serious or life-threatening side effects.
Here, we report a case of a patient with NSCLC with an fusion and was treated with alectinib but who developed grade 4 hyperbilirubinemia after five months on therapy. Alectinib was discontinued, and an artificial liver support system (ALSS) was used with an impressive decline in bilirubin levels. After two months drug-free, the patient experienced disease progression. Ensartinib was initiated as second-line treatment with a best response of stable disease after three months of therapy with no evidence of hyperbilirubinemia.
This is the first report of ensartinib treatment after alectinib-induced hyperbilirubinemia which was successfully relieved by ALSS treatment and targeted drug cessation.
阿来替尼被批准用于治疗携带ALK重排的晚期非小细胞肺癌（NSCLC）。尽管阿来替尼总体耐受性良好，但它可能会引起严重或危及生命的副作用。
在此，我们报告一例NSCLC患者，其存在 融合，接受阿来替尼治疗，但在治疗五个月后出现4级高胆红素血症。停用阿来替尼，并使用人工肝支持系统（ALSS），胆红素水平显著下降。在停药两个月后，患者病情进展。恩沙替尼作为二线治疗药物开始使用，治疗三个月后最佳疗效为病情稳定，且无高胆红素血症迹象。
这是第一例关于阿来替尼引起高胆红素血症后使用恩沙替尼治疗的报告，通过ALSS治疗和停用靶向药物，高胆红素血症成功得到缓解。
