Pharmacokinetics of alectinib and its metabolite M4 in a patient with advanced lung adenocarcinoma undergoing hemodialysis: A case report

This study presents the first detailed pharmacokinetic data of alectinib and its metabolite M4 in a patient with anaplastic lymphoma kinase (ALK)‐rearranged lung adenocarcinoma undergoing hemodialysis. When the patient was administered a daily 300 mg bid dose of alectinib, the maximal observed plasma concentration (Cmax) of alectinib and M4 were 638 and 82 ng/ml, respectively, at steady‐state (day 9). These pharmacokinetic data were similar to those previously reported in patients with normal organ function. The trough plasma concentration (Ctrough) of alectinib and M4 on the hemodialysis day were 562 and 66 ng/ml, respectively, identical to those on post‐hemodialysis day. He remains well and in partial remission 12 months after his diagnosis. We believe that alectinib is feasible and effective for patients with ALK‐rearranged non‐small cell lung cancer undergoing hemodialysis. This study presents the first detailed pharmacokinetic data of alectinib and its metabolite M4 in a patient with anaplastic lymphoma kinase (ALK)‐rearranged lung adenocarcinoma undergoing hemodialysis. When the patient was administered a daily 300 mg bid dose of alectinib, pharmacokinetic data were similar to those previously reported in patients with normal organ function. Alectinib is feasible and effective for patients with ALK‐rearranged non‐small cell lung cancer undergoing hemodialysis.