title: Successful oral desensitization against skin rash induced by alectinib in a patient with anaplastic lymphoma kinase-positive lung adenocarcinoma: A case report.
abstract: Alectinib has been approved for the treatment of patients with anaplastic lymphoma kinase (ALK) gene rearrangement-positive advanced non-small cell lung cancer. In terms of adverse effects, the occurrence of a severe skin rash induced by alectinib is reportedly rare, compared with the occurrence of skin rash induced by epithelial growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). In the present case report, a 76-year-old woman with ALK-positive lung adenocarcinoma experienced disease progression after undergoing first-line chemotherapy. Subsequently, alectinib was administered as a second-line therapy. However, she discontinued alectinib therapy after 11days because of the occurrence of an alectinib-induced skin rash. Since the skin rash improved within one week, we attempted to perform oral desensitization to alectinib. The patient has not shown any recurrence of the rash or disease progression for 7 months since the successful oral desensitization to alectinib. Here, we describe the first case of successful oral desensitization against a skin rash induced by alectinib in a patient with ALK-positive lung adenocarcinoma. Desensitization to overcome adverse effects and to enable sustained treatment with alectinib should be considered in patients who develop alectinib sensitivities.
authors: Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan. Electronic address: sirasawa@kitasato-u.ac.jp.
authors: Masayuki
authors: M
authors: Shirasawa
authors: Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan. Electronic address: masakubo@kitasato-u.ac.jp.
authors: Masaru
authors: M
authors: Kubotaa
authors: Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan. Electronic address: shinya.h@kitasato-u.ac.jp.
authors: Shinya
authors: S
authors: Harada
authors: Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan. Electronic address: niwahide@kitasato-u.ac.jp.
authors: Hideyuki
authors: H
authors: Niwa
authors: Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan. Electronic address: kusuhara@kitasato-u.ac.jp.
authors: Seiichiro
authors: S
authors: Kusuhara
authors: Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan. Electronic address: kasajima@kitasato-u.ac.jp.
authors: Masashi
authors: M
authors: Kasajima
authors: Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan. Electronic address: hiyoshi@kitasato-u.ac.jp.
authors: Yasuhiro
authors: Y
authors: Hiyoshi
authors: Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan. Electronic address: stonefld@kitasato-u.ac.jp.
authors: Mikiko
authors: M
authors: Ishihara
authors: Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan. Electronic address: igawa@kitasato-u.ac.jp.
authors: Satoshi
authors: S
authors: Igawa
authors: Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan. Electronic address: masuda@med.kitasato-u.ac.jp.
authors: Noriyuki
authors: N
authors: Masuda
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism*; D000077192:Adenocarcinoma of Lung; D000368:Aged; D000077548:Anaplastic Lymphoma Kinase; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001706:Biopsy; D002227:Carbazoles / Q000009:adverse effects* / Q000627:therapeutic use; D003888:Desensitization, Immunologic; D005076:Exanthema / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism*; D010880:Piperidines / Q000009:adverse effects* / Q000627:therapeutic use; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D020794:Receptor Protein-Tyrosine Kinases / Q000378:metabolism*
chemical_list: 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
keywords: Alectinib; Anaplastic lymphoma kinase (ALK) gene rearrangement; Desensitization; Skin rash