Alectinib-induced anemia with acanthocytosis: To proceed or discontinue treatment in Non-Small Cell Lung Cancer patients?

Authors

DOI:

https://doi.org/10.32932/gecp.2023.12.048

Keywords:

Adverse events, tyrosine kinase inhibitors, non-small-cell lung cancer, treatment

Abstract

ALK gene rearrangements are important oncogenic driver alterations in non-small-cell lung cancer and a predictive factor. When present, it enables the use of tyrosine kinase inhibitors, such as Alectinib. This drug can lead to anemia and erythrocyte morphological changes. We present the case of a 72-year-old patient diagnosed with stage IV non-small cell lung cancer treated with Alectinib in the first line. The drug was very effective in reducing the tumor size but with G2 anemia and acanthocytosis as side effects. Anemia was improved once Alectinib was replaced by Brigatinib.

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Author Biography

  • Telma Sequeira, Serviço de Oncologia, Hospital de Faro; Departamento de Genética, Faculdade Medicina Universidade de Lisboa

     

     

References

Gullapalli V, Xu W, Lewis CR, Anazodo A, Gerber GK. A multi-centre case series of alectinib-related erythrocyte membrane changes and associated haemolysis. J Hematop. 2021;14(2):131–6.

Kunz J, Wiedemann C, Grosch H, Kriegsmann K, Gryzik S, Felden J, et al. Early Development of Ubiquitous Acanthocytosis and Extravascular Hemolysis in Lung Cancer Patients Receiving Alectinib. Cancers (Basel). 2022;14(11).

Peters S, Camidge DR, Shaw AT, Gadgeel S, Ahn JS, Kim D-W, et al. Alectinib versus Crizotinib in Untreated ALK -Positive Non–Small-Cell Lung Cancer. N Engl J Med. 2017;377(9):829–38.

Misawa K, Nakamichi S, Iida H, Nagano A, Mikami E, Tozuka T, et al. Alectinib-Induced Severe Hemolytic Anemia in a Patient with ALK-Positive Non-Small Cell Lung Cancer: A Case Report. Onco Targets Ther. 2023;16(January):65–9.

European Medicines Agency. Annex I - Summary of Product Characteristics. In: Alecensa: Alectinib [Internet]. London: EMA; 2017 [updated 2023 Mar 29]. Available from: https://www.ema.europa.eu/en/ documents/product-information/alecensa-epar--product-informat.

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Published

2024-11-19

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Section

Clinical Case

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