title: Acute interstitial lung disease in a patient with anaplastic lymphoma kinase-positive non-small-cell lung cancer after crizotinib therapy.
abstract: Crizotinib, an orally active multi-targeted small-molecule anaplastic lymphoma kinase (ALK) inhibitor, is an effective treatment modality for advanced ALK-positive non-small-cell lung cancer (NSCLC). Most drug-related adverse events are mild to moderate; however, some patients may develop acute interstitial lung disease (ILD) which is sometimes fatal. We present a case of crizotinib-associated ILD in a 47-year-old woman treated with crizotinib for metastatic adenocarcinoma of the lung. The patient presented with acute breathlessness and hypoxaemia in the second month of crizotinib therapy; radiological and histopathological work-up was suggestive of acute interstitial pneumonia. The patient improved clinically with corticosteroid therapy and was successfully re-challenged with crizotinib. In conclusion, while treating NSCLC patients with crizotinib, it is important to promptly investigate and treat any new-onset respiratory symptoms, as the latter could represent an adverse effect related to therapy. Prompt discontinuation of the offending drug and initiation of corticosteroid therapy may prevent adverse outcomes.
authors.affiliation: Department of Medical Oncology , M. S. Ramaiah Medical College , MSRIT Post, Bangalore 560054 , India.
authors.forename: Vinayak V
authors.initials: VV
authors.lastname: Maka
authors.affiliation: Department of Chest Medicine , M. S. Ramaiah Medical College , MSRIT Post, Bangalore 560054 , India.
authors.forename: Uma Maheshwari
authors.initials: UM
authors.lastname: Krishnaswamy
authors.affiliation: Department of Medical Oncology , M. S. Ramaiah Medical College , MSRIT Post, Bangalore 560054 , India.
authors.forename: N
authors.initials: N
authors.lastname: Anil Kumar
authors.affiliation: Department of Medical Oncology , M. S. Ramaiah Medical College , MSRIT Post, Bangalore 560054 , India.
authors.forename: Rohith
authors.initials: R
authors.lastname: Chitrapur
authors.affiliation: Department of Medical Oncology , M. S. Ramaiah Medical College , MSRIT Post, Bangalore 560054 , India.
authors.forename: Nalini
authors.initials: N
authors.lastname: Kilara