Case report: Dissolving carotid plaque associated to Lorlatinib-related dyslipidemia

Lukas Mayer-Suess; Michael Knoflach; Andreas Pircher; Stefan Kiechl; Christoph Schmidauer; Eva Hametner

doi:10.3389/fonc.2024.1322501

Case report: Dissolving carotid plaque associated to Lorlatinib-related dyslipidemia

Front Oncol. 2024 Mar 5:14:1322501. doi: 10.3389/fonc.2024.1322501. eCollection 2024.

Authors

Lukas Mayer-Suess¹, Michael Knoflach^{1

2}, Andreas Pircher³, Stefan Kiechl^{1

2}, Christoph Schmidauer¹, Eva Hametner¹

Affiliations

¹ Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
² VASCage, Centre on Clinical Stroke Research, Innsbruck, Austria.
³ Department of Internal Medicine V, Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria.

Abstract

We present a case with prolonged Lorlatinib-related dyslipidemia causing internal carotid artery stenosis, putting the patient at risk of cerebrovascular events. Through intensified lipid-lowering treatment and dose reduction of Lorlatinib, LDL-C levels decreased markedly. Surprisingly, the left sided internal carotid artery stenosis dissolved accordingly. Due to the high efficacy of the new selective tyrosine kinase inhibitors and resulting long-term treatment, it is essential to carefully follow-up and include drug specific side effect monitoring. This case emphasizes that Loraltinib-related dyslipidemia has to be taken seriously and treatment should be initiated as promptly as possible. We conclude that in cases were lipid dysregulation remains and Lorlatinib treatment has to be continued, cerebrovascular appraisal through ultrasound should be considered and, if stenosis is evident, intensified treatment regimen of dyslipidemia or dose reduction of Lorlatinib should be discussed in an interdisciplinary setting.

Keywords: LDL-C; Lorlatinib; case report; dyslipidemia; stroke.

Publication types

Case Reports

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study is supported by VASCage – Research Centre on Clinical Stroke Research. VASCage is a COMET Centre within the Competence Centers for Excellent Technologies (COMET) programme and funded by the Federal Ministry for Climate Action, Environment, Energy, Mobility, Innovation and Technology, the Federal Ministry of Labour and Economy, and the federal states of Tyrol, Salzburg and Vienna. COMET is managed by the Austrian Research Promotion Agency (Österreichische Forschungsförderungsgesellschaft). FFG Project number: 898252.