title: Resolution of lung adenocarcinoma after discontinuation of ibrutinib.
abstract: The new capability to generate mimicking chemical analogues and perform mass screenings of candidate drugs has been tested on B-cell receptor signalling, a driver of B-cell malignancies. These efforts have identified ibrutinib as a potent inhibitor of Bruton's tyrosine kinase. As the clinical use of ibrutinib increases, continued vigilant monitoring for rare adverse events is prudent, including the development of secondary malignancies. To date, the most common reported secondary malignancy is non-melanoma skin cancer; however, we present a case of secondary primary lung adenocarcinoma becoming clinically apparent shortly after initiating therapy with ibrutinib. Our patient had a sudden regression of the tumour with discontinuance of ibrutinib, and based on our understanding of paradoxical tumour growth caused by tyrosine kinase inhibitors it is our hypothesis that the complex multikinase activity of ibrutinib may stimulate tumour growth by targeting a subset of protein kinases critical for growth in some cancer cells.
authors.affiliation: Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, Texas, USA Department of Internal Medicine, Lankenau Medical Center, Wynnewood, Pennsylvania, USA.
authors.forename: Tamer
authors.initials: T
authors.lastname: Khashab
authors.affiliation: Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Sanam
authors.initials: S
authors.lastname: Loghavi
authors.affiliation: Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Sergej N
authors.initials: SN
authors.lastname: Konoplev
authors.affiliation: Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Felipe
authors.initials: F
authors.lastname: Samaniego
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives; D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000188:drug therapy*; D000077192:Adenocarcinoma of Lung; D000368:Aged; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D010880:Piperidines; D011720:Pyrazoles / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
chemical_list: D010880:Piperidines; D011720:Pyrazoles; D011743:Pyrimidines; C551803:ibrutinib; D000225:Adenine