Successful Treatment with Low-dose Crizotinib in a Patient with ROS1-rearranged Lung Cancer Who Developed Crizotinib-induced Heart Failure

Intern Med. 2023 Jan 15;62(2):281-284. doi: 10.2169/internalmedicine.9157-21. Epub 2022 Jun 21.

Abstract

Crizotinib shows antitumor activity against C-ros oncogene 1-rearranged non-small-cell lung cancer (NSCLC). While corrected QT interval (QTc) prolongation and bradycardia are known as cardiac adverse effects, little is known about crizotinib-related heart failure. Our patient with C-ros oncogene 1-rearranged NSCLC on a reduced dose of crizotinib (200 mg twice daily) after initially experiencing bradycardia and QTc prolongation developed crizotinib-induced heart failure. With further dose reduction (250 mg once daily), there was no recurrence of any cardiac adverse effects, and the patient achieved a long-term response. Although crizotinib can cause heart failure, continuation of crizotinib at a low dose may be an effective treatment option.

Keywords: QTc prolongation; ROS1-rearrangement; cardiotoxicity; crizotinib; heart failure.

MeSH terms

  • Bradycardia / chemically induced
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Carcinoma, Non-Small-Cell Lung* / genetics
  • Carcinoma, Non-Small-Cell Lung* / pathology
  • Crizotinib / adverse effects
  • Gene Rearrangement
  • Heart Failure* / chemically induced
  • Heart Failure* / drug therapy
  • Humans
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / genetics
  • Lung Neoplasms* / pathology
  • Protein Kinase Inhibitors / adverse effects
  • Protein-Tyrosine Kinases
  • Proto-Oncogene Proteins / genetics
  • Reactive Oxygen Species / therapeutic use

Substances

  • Crizotinib
  • Protein-Tyrosine Kinases
  • Reactive Oxygen Species
  • Proto-Oncogene Proteins
  • Protein Kinase Inhibitors
  • ROS1 protein, human