Chen Xianmeng, Xia Daqing, Jiang Xuqin, Cao Lejie, Ryu Jay H, Hu Xiaowen
Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States.
Front Pharmacol. 2022 Nov 1;13:944685. doi: 10.3389/fphar.2022.944685. eCollection 2022.
Molecular targeting therapy is becoming the standard of care for some patients with anaplastic lymphoma kinase (ALK)-rearranged lung adenocarcinoma. Drug-related pneumonitis (DRP) has been identified as an infrequent but potentially severe adverse effect. Herein, we report a 50-year-old woman with ALK-rearranged advanced lung adenocarcinoma who developed interstitial lung disease associated with alectinib therapy. At 102-day of treatment, chest CT revealed scattered ground glass opacities (GGOs) involving both lungs. Since she was asymptomatic and alectinib provided a beneficial tumor treatment response, alectinib therapy was continued. However, 2 months later, she presented with progressive dyspnea and diffuse GGOs on chest computed tomography. There was no evidence for infection or other etiologies for her lung complication. Alectinib was discontinued and steroid therapy was initiated which was followed by improvement in respiratory symptoms and chest CT findings; DRP was diagnosed. Although rare, alectinib therapy can cause DRP of indolent onset.
分子靶向治疗正成为一些间变性淋巴瘤激酶（ALK）重排的肺腺癌患者的标准治疗方法。药物相关性肺炎（DRP）已被确定为一种罕见但可能严重的不良反应。在此，我们报告一名50岁患有ALK重排的晚期肺腺癌女性，她在接受阿来替尼治疗时出现了间质性肺病。治疗第102天时，胸部CT显示双肺散在磨玻璃影（GGO）。由于她无症状且阿来替尼对肿瘤治疗有效，故继续使用阿来替尼治疗。然而，2个月后，她出现进行性呼吸困难，胸部计算机断层扫描显示弥漫性GGO。没有证据表明其肺部并发症是由感染或其他病因引起的。停用阿来替尼并开始使用类固醇治疗，随后呼吸道症状和胸部CT表现有所改善；诊断为DRP。尽管罕见，但阿来替尼治疗可导致起病隐匿的DRP。
