Godallage Anuradha Nalika, Sivapalan Pradeesh, Horvat Vladmira, Trøster Simon, Kolekar Shailesh
Department of Medicine 1, Slagelse Hospital, Slagelse, Denmark.
Copenhagen Respiratory Research, Department of Medicine, Herlev and Gentofte Hospital, Hellerup, Denmark.
Korean J Clin Oncol. 2025 Aug;21(2):105-108. doi: 10.14216/kjco.25332. Epub 2025 Aug 31.
Approximately 3% to 5% of individuals with oncogenic rearrangements in the anaplastic lymphoma kinase (ALK) gene develop non-small cell lung cancer (NSCLC). Brigatinib, a potent next-generation ALK tyrosine kinase inhibitor (TKI), has demonstrated significant systemic and intracranial responses, as well as improved progression-free survival, with an acceptable safety profile. According to European Society for Medical Oncology guidelines patients with ALK translocation and performance status 0-3 can be offered 1st line treatment with TKI (brigatinib, alectinib, or lorlatinib). To our knowledge, this is the first reported case of cystic or bullous changes in the lungs following incremental dosing of brigatinib. Here, we describe a 37-year-old male, a never-smoker, who developed progressively diffuse cystic changes in the lung parenchyma while receiving brigatinib treatment for NSCLC with intrapulmonary metastases. Clinicians should remain vigilant for this potential atypical pulmonary adverse effect, including the possibility of cystic or bullous transformations in the lung parenchyma.
在间变性淋巴瘤激酶（ALK）基因发生致癌重排的个体中，约3%至5%会发展为非小细胞肺癌（NSCLC）。布加替尼是一种强效的新一代ALK酪氨酸激酶抑制剂（TKI），已显示出显著的全身和颅内反应，以及无进展生存期的改善，且安全性可接受。根据欧洲医学肿瘤学会指南，ALK易位且体能状态为0 - 3的患者可接受TKI（布加替尼、阿来替尼或洛拉替尼）一线治疗。据我们所知，这是首次报道布加替尼递增给药后肺部出现囊性或大疱性改变的病例。在此，我们描述一名37岁从不吸烟的男性，他在接受布加替尼治疗伴有肺内转移的NSCLC时，肺实质出现了逐渐加重的弥漫性囊性改变。临床医生应警惕这种潜在的非典型肺部不良反应，包括肺实质发生囊性或大疱性转变的可能性。
