Successful Treatment with Ensartinib After Alectinib-induced Hyperbilirubinemia in ALK-Positive NSCLC
Background: Alectinib is approved for the treatment of advanced non-small-cell lung cancer (NSCLC) harboring ALK rearrangements. Although generally well tolerated, alectinib can cause serious or life-threatening side effects. Case Presentation: Here, we report a case of a patient with NSCLC with an...
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| Veröffentlicht in: | OncoTargets and therapy 2021-01, Vol.14, p.3409-3415 |
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| creator | Peng, Ling Xiao, Kui Cui, Jian Ye, Xiang-Hua Zhang, Yong-Chang Mao, Li Selvaggi, Giovanni Yen, Jennifer Stebbing, Justin |
| description | Background: Alectinib is approved for the treatment of advanced non-small-cell lung cancer (NSCLC) harboring ALK rearrangements. Although generally well tolerated, alectinib can cause serious or life-threatening side effects.
Case Presentation: Here, we report a case of a patient with NSCLC with an EML4-ALK fusion and was treated with alectinib but who developed grade 4 hyperbilirubinemia after five months on therapy. Alectinib was discontinued, and an artificial liver support system (ALSS) was used with an impressive decline in bilirubin levels. After two months drug-free, the patient experienced disease progression. Ensartinib was initiated as second-line treatment with a best response of stable disease after three months of therapy with no evidence of hyperbilirubinemia.
Conclusion: This is the first report of ensartinib treatment after alectinib-induced hyperbilirubinemia which was successfully relieved by ALSS treatment and targeted drug cessation. |
| doi_str_mv | 10.2147/OTT.S310756 |
| format | Article |
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Case Presentation: Here, we report a case of a patient with NSCLC with an EML4-ALK fusion and was treated with alectinib but who developed grade 4 hyperbilirubinemia after five months on therapy. Alectinib was discontinued, and an artificial liver support system (ALSS) was used with an impressive decline in bilirubin levels. After two months drug-free, the patient experienced disease progression. Ensartinib was initiated as second-line treatment with a best response of stable disease after three months of therapy with no evidence of hyperbilirubinemia.
Conclusion: This is the first report of ensartinib treatment after alectinib-induced hyperbilirubinemia which was successfully relieved by ALSS treatment and targeted drug cessation.</description><identifier>ISSN: 1178-6930</identifier><identifier>EISSN: 1178-6930</identifier><identifier>DOI: 10.2147/OTT.S310756</identifier><identifier>PMID: 34079286</identifier><language>eng</language><publisher>ALBANY: Dove Medical Press Ltd</publisher><subject>Antimitotic agents ; Antineoplastic agents ; Bilirubin ; Biotechnology & Applied Microbiology ; Care and treatment ; Case Report ; Case reports ; Development and progression ; Drug approval ; FDA approval ; Hepatitis ; Hyperbilirubinemia ; Life Sciences & Biomedicine ; Liver ; Liver cancer ; Lung cancer, Non-small cell ; Lymphatic system ; Medical imaging ; Metastasis ; Mutation ; Non-small cell lung carcinoma ; Oncology ; Pleural effusion ; Science & Technology ; Small cell lung carcinoma</subject><ispartof>OncoTargets and therapy, 2021-01, Vol.14, p.3409-3415</ispartof><rights>2021 Peng et al.</rights><rights>COPYRIGHT 2021 Dove Medical Press Limited</rights><rights>2021. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Peng et al. 2021 Peng et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>2</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000656139200001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c474t-9f8834c35d3cfd034915bbe275fb438073a2010585b925ce4b2c70b2e3349fa33</citedby><cites>FETCH-LOGICAL-c474t-9f8834c35d3cfd034915bbe275fb438073a2010585b925ce4b2c70b2e3349fa33</cites><orcidid>0000-0001-6519-713X ; 0000-0002-1359-4982 ; 0000-0002-6829-7176 ; 0000-0001-8015-8999 ; 0000-0002-1117-6947</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8164872/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8164872/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,886,3863,27929,27930,39263,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34079286$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peng, Ling</creatorcontrib><creatorcontrib>Xiao, Kui</creatorcontrib><creatorcontrib>Cui, Jian</creatorcontrib><creatorcontrib>Ye, Xiang-Hua</creatorcontrib><creatorcontrib>Zhang, Yong-Chang</creatorcontrib><creatorcontrib>Mao, Li</creatorcontrib><creatorcontrib>Selvaggi, Giovanni</creatorcontrib><creatorcontrib>Yen, Jennifer</creatorcontrib><creatorcontrib>Stebbing, Justin</creatorcontrib><title>Successful Treatment with Ensartinib After Alectinib-induced Hyperbilirubinemia in ALK-Positive NSCLC</title><title>OncoTargets and therapy</title><addtitle>ONCOTARGETS THER</addtitle><addtitle>Onco Targets Ther</addtitle><description>Background: Alectinib is approved for the treatment of advanced non-small-cell lung cancer (NSCLC) harboring ALK rearrangements. Although generally well tolerated, alectinib can cause serious or life-threatening side effects.
Case Presentation: Here, we report a case of a patient with NSCLC with an EML4-ALK fusion and was treated with alectinib but who developed grade 4 hyperbilirubinemia after five months on therapy. Alectinib was discontinued, and an artificial liver support system (ALSS) was used with an impressive decline in bilirubin levels. After two months drug-free, the patient experienced disease progression. Ensartinib was initiated as second-line treatment with a best response of stable disease after three months of therapy with no evidence of hyperbilirubinemia.
Conclusion: This is the first report of ensartinib treatment after alectinib-induced hyperbilirubinemia which was successfully relieved by ALSS treatment and targeted drug cessation.</description><subject>Antimitotic agents</subject><subject>Antineoplastic agents</subject><subject>Bilirubin</subject><subject>Biotechnology & Applied Microbiology</subject><subject>Care and treatment</subject><subject>Case Report</subject><subject>Case reports</subject><subject>Development and progression</subject><subject>Drug approval</subject><subject>FDA approval</subject><subject>Hepatitis</subject><subject>Hyperbilirubinemia</subject><subject>Life Sciences & Biomedicine</subject><subject>Liver</subject><subject>Liver cancer</subject><subject>Lung cancer, Non-small cell</subject><subject>Lymphatic system</subject><subject>Medical imaging</subject><subject>Metastasis</subject><subject>Mutation</subject><subject>Non-small cell lung carcinoma</subject><subject>Oncology</subject><subject>Pleural effusion</subject><subject>Science & Technology</subject><subject>Small cell lung carcinoma</subject><issn>1178-6930</issn><issn>1178-6930</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkt9rFDEQxxdRbK0--S4LQl9kz_za3eyLcCzViocV7nwOSXbSS9lLziTb0v_e1J7XO_BB5iGT5DNfZoZvUbzFaEYwaz9erVazJcWorZtnxSnGLa-ajqLnB_lJ8SrGG4SahhP2sjihDLUd4c1pActJa4jRTGO5CiDTBlwq72xalxcuypCss6qcmwShnI-g_9wr64ZJw1Be3m8hKDvaMCnrYGNlaV05X3yrfvhok72F8vuyX_SvixdGjhHe7M6z4ufni1V_WS2uvnzt54tKs5alqjOcU6ZpPVBtBkRZh2ulgLS1UYxy1FJJEEY1r1VHag1MEd0iRYBm1EhKz4pPj7rbSW1g0HmWIEexDXYjw73w0orjH2fX4trfCo4bxluSBd7vBIL_NUFM4sZPweWeBakZ5nmBnD5R13IEYZ3xWUxvbNRi3rQ0B69xpmb_oHIMeVHaOzA2vx8VnB8UrEGOaR39OCXrXTwGPzyCOvgYA5j9hBiJB0-I7Amx80Sm3x0uZc_-NUEG-CNwB8qbqC04DXsMZdvUDaYdyRnCvU3yoaHeTy49dfI_pfQ3UVzQ6g</recordid><startdate>20210101</startdate><enddate>20210101</enddate><creator>Peng, Ling</creator><creator>Xiao, Kui</creator><creator>Cui, Jian</creator><creator>Ye, Xiang-Hua</creator><creator>Zhang, Yong-Chang</creator><creator>Mao, Li</creator><creator>Selvaggi, Giovanni</creator><creator>Yen, Jennifer</creator><creator>Stebbing, Justin</creator><general>Dove Medical Press Ltd</general><general>Dove Medical Press Limited</general><general>Taylor & Francis Ltd</general><general>Dove</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6519-713X</orcidid><orcidid>https://orcid.org/0000-0002-1359-4982</orcidid><orcidid>https://orcid.org/0000-0002-6829-7176</orcidid><orcidid>https://orcid.org/0000-0001-8015-8999</orcidid><orcidid>https://orcid.org/0000-0002-1117-6947</orcidid></search><sort><creationdate>20210101</creationdate><title>Successful Treatment with Ensartinib After Alectinib-induced Hyperbilirubinemia in ALK-Positive NSCLC</title><author>Peng, Ling ; Xiao, Kui ; Cui, Jian ; Ye, Xiang-Hua ; Zhang, Yong-Chang ; Mao, Li ; Selvaggi, Giovanni ; Yen, Jennifer ; Stebbing, Justin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-9f8834c35d3cfd034915bbe275fb438073a2010585b925ce4b2c70b2e3349fa33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Antimitotic agents</topic><topic>Antineoplastic agents</topic><topic>Bilirubin</topic><topic>Biotechnology & Applied Microbiology</topic><topic>Care and treatment</topic><topic>Case Report</topic><topic>Case reports</topic><topic>Development and progression</topic><topic>Drug approval</topic><topic>FDA approval</topic><topic>Hepatitis</topic><topic>Hyperbilirubinemia</topic><topic>Life Sciences & Biomedicine</topic><topic>Liver</topic><topic>Liver cancer</topic><topic>Lung cancer, Non-small cell</topic><topic>Lymphatic system</topic><topic>Medical imaging</topic><topic>Metastasis</topic><topic>Mutation</topic><topic>Non-small cell lung carcinoma</topic><topic>Oncology</topic><topic>Pleural effusion</topic><topic>Science & Technology</topic><topic>Small cell lung carcinoma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peng, Ling</creatorcontrib><creatorcontrib>Xiao, Kui</creatorcontrib><creatorcontrib>Cui, Jian</creatorcontrib><creatorcontrib>Ye, Xiang-Hua</creatorcontrib><creatorcontrib>Zhang, Yong-Chang</creatorcontrib><creatorcontrib>Mao, Li</creatorcontrib><creatorcontrib>Selvaggi, Giovanni</creatorcontrib><creatorcontrib>Yen, Jennifer</creatorcontrib><creatorcontrib>Stebbing, Justin</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>OncoTargets and therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Peng, Ling</au><au>Xiao, Kui</au><au>Cui, Jian</au><au>Ye, Xiang-Hua</au><au>Zhang, Yong-Chang</au><au>Mao, Li</au><au>Selvaggi, Giovanni</au><au>Yen, Jennifer</au><au>Stebbing, Justin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Successful Treatment with Ensartinib After Alectinib-induced Hyperbilirubinemia in ALK-Positive NSCLC</atitle><jtitle>OncoTargets and therapy</jtitle><stitle>ONCOTARGETS THER</stitle><addtitle>Onco Targets Ther</addtitle><date>2021-01-01</date><risdate>2021</risdate><volume>14</volume><spage>3409</spage><epage>3415</epage><pages>3409-3415</pages><issn>1178-6930</issn><eissn>1178-6930</eissn><abstract>Background: Alectinib is approved for the treatment of advanced non-small-cell lung cancer (NSCLC) harboring ALK rearrangements. Although generally well tolerated, alectinib can cause serious or life-threatening side effects.
Case Presentation: Here, we report a case of a patient with NSCLC with an EML4-ALK fusion and was treated with alectinib but who developed grade 4 hyperbilirubinemia after five months on therapy. Alectinib was discontinued, and an artificial liver support system (ALSS) was used with an impressive decline in bilirubin levels. After two months drug-free, the patient experienced disease progression. Ensartinib was initiated as second-line treatment with a best response of stable disease after three months of therapy with no evidence of hyperbilirubinemia.
Conclusion: This is the first report of ensartinib treatment after alectinib-induced hyperbilirubinemia which was successfully relieved by ALSS treatment and targeted drug cessation.</abstract><cop>ALBANY</cop><pub>Dove Medical Press Ltd</pub><pmid>34079286</pmid><doi>10.2147/OTT.S310756</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-6519-713X</orcidid><orcidid>https://orcid.org/0000-0002-1359-4982</orcidid><orcidid>https://orcid.org/0000-0002-6829-7176</orcidid><orcidid>https://orcid.org/0000-0001-8015-8999</orcidid><orcidid>https://orcid.org/0000-0002-1117-6947</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Antimitotic agents Antineoplastic agents Bilirubin Biotechnology & Applied Microbiology Care and treatment Case Report Case reports Development and progression Drug approval FDA approval Hepatitis Hyperbilirubinemia Life Sciences & Biomedicine Liver Liver cancer Lung cancer, Non-small cell Lymphatic system Medical imaging Metastasis Mutation Non-small cell lung carcinoma Oncology Pleural effusion Science & Technology Small cell lung carcinoma |
| title | Successful Treatment with Ensartinib After Alectinib-induced Hyperbilirubinemia in ALK-Positive NSCLC |
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