Zhu Ning, Lin Shanhong, He Lei, Wang Linfeng, Kong Weiliang, Cao Chao
Department of Respiratory and Critical Care Medicine, Ningbo First Hospital, Ningbo, China.
Department of Ultrasound, Ningbo First Hospital, Ningbo, China.
SAGE Open Med Case Rep. 2021 Aug 31;9:2050313X211042991. doi: 10.1177/2050313X211042991. eCollection 2021.
Although alectinib is a well-tolerated and highly effective inhibitor of a second-generation anaplastic lymphoma kinase, special attention should be paid to the possibility of potentially severe and fatal adverse events such as interstitial pneumonia. We report a case of a patient with advanced non-small cell lung cancer treated with alectinib who developed immunohistochemically positive anaplastic lymphoma kinase (ALK(IHC +)) . However, due to the rapid emergence of drug-induced interstitial lung disease, alectinib treatment was halted. Once the interstitial lung disease had been successfully treated, we reluctantly chose crizotinib as a second-line treatment for ALK + NSCLC in this patient as he refused all other available treatments. Contrary to expectation, crizotinib performed well both in terms of its safety and efficacy. Our results suggest that crizotinib may provide a promising therapy option for patients with ALK + NSCLC accompanied by alectinib-induced interstitial lung disease. To our knowledge, this is a rare report of successful treatment of ALK + NSCLC with crizotinib after alectinib-induced interstitial lung disease.
尽管阿来替尼是一种耐受性良好且高效的第二代间变性淋巴瘤激酶抑制剂，但应特别关注潜在的严重和致命不良事件，如间质性肺炎的可能性。我们报告了一例晚期非小细胞肺癌患者，接受阿来替尼治疗后出现免疫组化阳性的间变性淋巴瘤激酶（ALK(IHC +)）。然而，由于药物性间质性肺病迅速出现，阿来替尼治疗被中止。一旦间质性肺病成功治愈，由于该患者拒绝所有其他可用治疗，我们无奈选择克唑替尼作为该ALK + 非小细胞肺癌患者的二线治疗药物。与预期相反，克唑替尼在安全性和疗效方面均表现良好。我们的结果表明，克唑替尼可能为伴有阿来替尼诱导的间质性肺病的ALK + 非小细胞肺癌患者提供一种有前景的治疗选择。据我们所知，这是一篇关于阿来替尼诱导的间质性肺病后用克唑替尼成功治疗ALK + 非小细胞肺癌的罕见报道。
