Crizotinib
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Elevated liver enzymes and development of resistance in primary lung adenocarcinoma: case report A 90-year-old woman developed elevated liver enzymes during treatment with crizotinib for primary lung adenocarcinoma and breast carcinoma. Further, she acquired resistance to crizotinib. The woman, who was diagnosed with left lung adenocarcinoma in June 2017, received general chemotherapy without response. She therefore underwent thoracentesis. Subsequently, she was found to have a ros1 translocation. In July 2017, she started receiving treatment with crizotinib [initial dosage not stated; route not stated]. However, she developed crizotinib-related increase in alanine aminotransferase levels and aspartate aminotransferase levels. The woman’s crizotinib was reduced to 250mg once daily. Within one month, she showed significant improvement with decreased pleural effusion. Re-evaluations at 4, 6, 10 and 11 months were unremarkable, suggestive of stable disease. However, the response only lasted for 10 months; the tumour grew, and became resistant to crizotinib. Subsequent scans showed that the pleural nodule had increased in size. As there were no available second-line therapies, crizotinib was continued with a scheduled re-escalation. Subsequently, she received hormone therapy, but her disease continued to progress. She eventually died 14 months after the diagnosis. Author comment: "In July 2017, the patient was started on crizotinib (250 mg once per day) as a result of an adverse effect (increased alanine aminotransferase, and aspartate aminotransferase levels)". "However, despite the initial response to crizotinib, the tumor became resistant to it and disease progressed in the pleura." Yang X, et al. An elderly female patient with ROS1 rearrangement primary lung adenocarcinoma and breast carcinoma: A rare case report and review of the literature. Precision Clinical Medicine 2: 197-203, No. 3, Sep 2019. Available 803435897 from: URL: http://doi.org/10.1093/pcmedi/pbz013 - China
0114-9954/19/1780-0001/$14.95 Adis © 2019 Springer Nature Switzerland AG. All rights reserved
Reactions 23 Nov 2019 No. 1780
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