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Interstitial lung disease: case report An 84-year-old man developed interstitial lung disease during treatment with crizotinib and alectinib for pulmonary adenocarcinoma [routes not stated; not all dosages stated]. The man presented with an abnormality on chest roentgenogram. He was diagnosed with stage IIIA pulmonary adenocarcinoma. Subsequently, he underwent surgical resection of the tumour. After 23 months of surgery, his pulmonary metastases reoccurred with echinoderm microtubule-associated protein-like 4‑ALK rearrangement. Therefore, he started receiving crizotinib 250mg twice daily. After, 4 months of crizotinib initiation, he developed dyspnoea and fever. A subsequent chest CT scan demonstrated extensive bilateral ground-glass opacities in both the lungs despite marked shrinkage of the pulmonary metastases. However, no pulmonary pathogens were noted. Because of his pulmonary opacities, a diagnosis of crizotinib induced interstitial lung disease was considered. Therefore, the man’s crizotinib was immediately stopped. He was started on methylprednisolone pulse therapy. This resulted in the improvement of his symptoms, as well as the pulmonary shadow resolved. However, after 3 months of termination of crizotinib, his tumour disease progressed. Therefore, he was initiated on alectinib. Thereafter, the spreading of the tumour was in control. However, 3 months later to his alectinib initiation, bilateral ground-glass opacities re-appeared in both the lungs. Similarly, no pulmonary pathogens were identified, and the location of this pulmonary shadow was the same as earlier interstitial lung disease induced by crizotinib. Immediately, alectinib was terminated. As a result, his pulmonary opacities resolved spontaneously. Kaira K, et al. Interstitial lung disease secondary to alectinib after interstitial injury induced by crizotinib. Journal of Cancer Research and Therapeutics 16: 919-921, No. 4, Jul-Sep 2020. Available from: URL: http://doi.org/10.4103/jcrt.JCRT_985_15 803517564

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Reactions 28 Nov 2020 No. 1832