BACKGROUND Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old...BACKGROUND Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old Asian patient.CASE SUMMARY The patient complained of dyspnea and upper abdominal pain for a week in August 2017. He was diagnosed with anaplastic lymphoma kinase-rearranged lung adenocarcinoma combined with multiple distant metastases. Crizotinib was initiated as a first-line treatment at a dosage of 250 mg twice daily. No adverse effects were seen until day 46. On day 55, he was admitted to the hospital with elevated liver enzymes aspartate aminotransferase(AST)(402 IU/L), alanine aminotransferase(ALT)(215 IU/L) and total bilirubin(145 μmol/L) and was diagnosed with crizotinib-induced fulminant liver failure. Despite crizotinib discontinuation and intensive supportive therapy, the level of AST(1075 IU/L),ALT(240 IU/L) and total bilirubin(233 μmol/L) continued to rapidly increase,and he died on day 60.CONCLUSION Physicians should be aware of the potential fatal adverse effects of crizotinib.展开更多
The advent of targeted molecular therapy against the EML4-ALK fusion gene is the latest therapeutic intervention for a subset of patients with non-small cell lung cancer (NSCLC). Crizotinib (Xalkori) is an orally avai...The advent of targeted molecular therapy against the EML4-ALK fusion gene is the latest therapeutic intervention for a subset of patients with non-small cell lung cancer (NSCLC). Crizotinib (Xalkori) is an orally available small molecule tyrosine kinase inhibitor proven in clinical trials to significantly impact progression free survival and overall response rate. We present a case of a 56-year-old male with NSCLC whose lack of a positive treatment response to this therapy led to the clinical suspicion and identification of the underdiagnosed entity known as synchronous multiple primary lung cancer (SMPLC).展开更多
记得1999年第一次去美国亚特兰大参加美国临床肿瘤学会（American Society of Clinical Oncology, ASCO）年会，当时将“分子靶向治疗”这个还觉陌生的名词仅仅与细胞和动物联系在了一起，感觉“服一片药代替化疗能够治疗肿瘤”就像“...记得1999年第一次去美国亚特兰大参加美国临床肿瘤学会（American Society of Clinical Oncology, ASCO）年会，当时将“分子靶向治疗”这个还觉陌生的名词仅仅与细胞和动物联系在了一起，感觉“服一片药代替化疗能够治疗肿瘤”就像“天方夜谭”或“美丽的童话”般遥远。而现实是时隔三年的2002年，第一个肺癌分子靶向治疗药物吉非替尼进入临床实践，此后更多分子靶向药物如雨后春笋般涌现。而其中表皮生长因子受体（epidermal growth factor receptor, EGFR）突变与EGFR酪氨酸激酶抑制剂（tyrosine kinase inhibitors, TKIs）疗效关系的精彩故事真正掀开了个体化分子靶向治疗的序幕。基于新的理念、新的思维设计的药物及全新的临床试验思路，从2007年肺癌患者A L K靶点发现至2011年针对间变性淋巴瘤激酶融合基因（anaplastic lymphoma kinase, ALK）的抑制剂克唑替尼获得美国食品药品监督管理局（Food and Drug Administration, FDA）许可上市，仅仅用4年的时间，便走完了EGF→EGFR→EGFR-TKI近乎40年的历程，转化性研究速度之快令人惊讶。展开更多
文摘BACKGROUND Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old Asian patient.CASE SUMMARY The patient complained of dyspnea and upper abdominal pain for a week in August 2017. He was diagnosed with anaplastic lymphoma kinase-rearranged lung adenocarcinoma combined with multiple distant metastases. Crizotinib was initiated as a first-line treatment at a dosage of 250 mg twice daily. No adverse effects were seen until day 46. On day 55, he was admitted to the hospital with elevated liver enzymes aspartate aminotransferase(AST)(402 IU/L), alanine aminotransferase(ALT)(215 IU/L) and total bilirubin(145 μmol/L) and was diagnosed with crizotinib-induced fulminant liver failure. Despite crizotinib discontinuation and intensive supportive therapy, the level of AST(1075 IU/L),ALT(240 IU/L) and total bilirubin(233 μmol/L) continued to rapidly increase,and he died on day 60.CONCLUSION Physicians should be aware of the potential fatal adverse effects of crizotinib.
文摘The advent of targeted molecular therapy against the EML4-ALK fusion gene is the latest therapeutic intervention for a subset of patients with non-small cell lung cancer (NSCLC). Crizotinib (Xalkori) is an orally available small molecule tyrosine kinase inhibitor proven in clinical trials to significantly impact progression free survival and overall response rate. We present a case of a 56-year-old male with NSCLC whose lack of a positive treatment response to this therapy led to the clinical suspicion and identification of the underdiagnosed entity known as synchronous multiple primary lung cancer (SMPLC).
文摘记得1999年第一次去美国亚特兰大参加美国临床肿瘤学会（American Society of Clinical Oncology, ASCO）年会，当时将“分子靶向治疗”这个还觉陌生的名词仅仅与细胞和动物联系在了一起，感觉“服一片药代替化疗能够治疗肿瘤”就像“天方夜谭”或“美丽的童话”般遥远。而现实是时隔三年的2002年，第一个肺癌分子靶向治疗药物吉非替尼进入临床实践，此后更多分子靶向药物如雨后春笋般涌现。而其中表皮生长因子受体（epidermal growth factor receptor, EGFR）突变与EGFR酪氨酸激酶抑制剂（tyrosine kinase inhibitors, TKIs）疗效关系的精彩故事真正掀开了个体化分子靶向治疗的序幕。基于新的理念、新的思维设计的药物及全新的临床试验思路，从2007年肺癌患者A L K靶点发现至2011年针对间变性淋巴瘤激酶融合基因（anaplastic lymphoma kinase, ALK）的抑制剂克唑替尼获得美国食品药品监督管理局（Food and Drug Administration, FDA）许可上市，仅仅用4年的时间，便走完了EGF→EGFR→EGFR-TKI近乎40年的历程，转化性研究速度之快令人惊讶。
