Regression of Crizotinib-Associated Complex Cystic Lesions after Switching to Alectinib

Intern Med. 2017 Sep 1;56(17):2321-2324. doi: 10.2169/internalmedicine.8445-16. Epub 2017 Aug 10.

Abstract

Crizotinib, which is effective in patients with anaplastic lymphoma kinase (ALK) positive non-small cell lung cancer, is sometimes associated with the generation of complex renal cysts. A 56-year-old man with ALK positive adenocarcinoma received crizotinib. Ten months after the introduction of crizotinib, a cystic lesion developed from his right kidney to the iliopsoas muscle, accompanied by fever, anemia, and hypoproteinemia. After 17 months of treatment, crizotinib was switched to alectinib, followed by the recovery of hypoproteinemia and systemic inflammation. Switching to alectinib may be beneficial in patients demonstrating crizotinib-associated complex renal cysts with systemic inflammation and exhaustion.

Keywords: alectinib; complex renal cysts; crizotinib; iliopsoas muscle; regression.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Antineoplastic Agents / therapeutic use
  • Carbazoles / therapeutic use
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Crizotinib
  • Humans
  • Kidney Diseases, Cystic / chemically induced*
  • Kidney Diseases, Cystic / drug therapy*
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Piperidines / therapeutic use
  • Protein Kinase Inhibitors / therapeutic use*
  • Pyrazoles / adverse effects*
  • Pyrazoles / therapeutic use
  • Pyridines / adverse effects*
  • Pyridines / therapeutic use
  • Receptor Protein-Tyrosine Kinases / therapeutic use*
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Carbazoles
  • Piperidines
  • Protein Kinase Inhibitors
  • Pyrazoles
  • Pyridines
  • Crizotinib
  • Receptor Protein-Tyrosine Kinases
  • alectinib