Interstitial lung disease induced by alectinib (CH5424802/RO5424802).
A 75-year-old woman with anaplastic lymphoma kinase (ALK)-rearranged Stage IV lung adenocarcinoma was administered the selective anaplastic lymphoma kinase inhibitor, alectinib, as a third-line treatment in a Phase 1-2 study. On the 102nd day, chest computed tomography showed diffuse ground glass opacities. Laboratory data revealed high serum levels of KL-6, SP-D and lactate dehydrogenase without any clinical symptoms. There was no evidence of infection. Marked lymphocytosis was seen in bronchoalveolar lavage fluid analysis, and transbronchial lung biopsy showed mild thickening of alveolar septa and lymphocyte infiltration. Interstitial lung disease was judged to be related to alectinib based on improvements in imaging findings and serum biomarkers after discontinuation of alectinib. To our knowledge, this is the first reported case of alectinib-induced interstitial lung disease. Alectinib is a promising drug for ALK-rearranged non-small cell lung cancer. Clinical trials of this selective anaplastic lymphoma kinase inhibitor will facilitate the meticulous elucidation of its long-term safety profile.
Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama isatoshi0112@gmail.com.
Satoshi
S
Ikeda
Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama.
Hiroshige
H
Yoshioka
Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama.
Machiko
M
Arita
Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama.
Takahiro
T
Sakai
Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama.
Naoyuki
N
Sone
Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama.
Akihiro
A
Nishiyama
Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama.
Takashi
T
Niwa
Department of Pathology, Kurashiki Central Hospital, Okayama.
Machiko
M
Hotta
Chugai Pharmaceutical Co., Ltd, Tokyo, Japan.
Tomohiro
T
Tanaka
Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama.
Tadashi
T
Ishida
D000230:Adenocarcinoma / Q000188:drug therapy*; D000077192:Adenocarcinoma of Lung; D000368:Aged; D000077548:Anaplastic Lymphoma Kinase; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001992:Bronchoalveolar Lavage Fluid; D002227:Carbazoles / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000139:chemically induced* / Q000175:diagnosis / Q000378:metabolism; D008175:Lung Neoplasms / Q000188:drug therapy*; D010880:Piperidines / Q000008:administration & dosage / Q000009:adverse effects*; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D020794:Receptor Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D014057:Tomography, X-Ray Computed
D000970:Antineoplastic Agents; D002227:Carbazoles; D010880:Piperidines; D047428:Protein Kinase Inhibitors; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases; C582670:alectinib
adverse event; alectinib; anaplastic lymphoma kinase; interstitial lung disease; non-small cell lung cancer