Open AccessClinical characteristics and risk factors of drug‐induced lung injury by ALK tyrosine kinase inhibitors: A single center retrospective analysis
Author(s) -
Koshikawa Ken,
Terada Jiro,
Abe Mitsuhiro,
Iwasawa Shunichiro,
Sakayori Masashi,
Yoshioka Keiichiro,
Hirasawa Yasutaka,
Kasai Hajime,
Kawasaki Yohei,
Tsushima Kenji,
Tatsumi Koichiro
Publication year - 2020
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/1759-7714.13416
Subject(s) - medicine , crizotinib , ceritinib , anaplastic lymphoma kinase , alectinib , lung cancer , oncology , malignant pleural effusion
Background If anaplastic lymphoma kinase (ALK) gene rearrangement in lung cancer is identified, ALK‐tyrosine kinase inhibitors (ALK‐TKIs) can be an effective treatment. However, the details of drug‐induced lung injury (DILI) caused by ALK‐TKI, which can be a serious side effect of ALK‐TKIs, remains unclear. This study aimed to investigate the clinical features and the onset risk factors of DILI by ALK‐TKIs in clinical practice. Methods The clinical features of 56 consecutive patients who received crizotinib, alectinib, and/or ceritinib at our hospital from 2012 to 2018 were retrospectively examined. Among these, patients diagnosed with DILI due to ALK‐TKIs were evaluated in terms of clinical features and parameters. Each clinical parameter before the administration of ALK‐TKIs was compared between the DILI onset group and the non‐onset group. Results A total of seven cases were diagnosed with DILI due to ALK‐TKIs; no DILI‐related deaths were observed. Chest computed tomography (CT) scan findings identified six patients with the organizing pneumonia (OP) pattern and one with the hypersensitivity pneumonia pattern. The onset of DILI was significantly different in patients age ≥ 64 years and with a creatinine clearance <80 mL/minute. Conclusions Extra caution for DILI due to ALK‐TKIs may be needed when recommending ALK‐TKIs for patients over 64 years of age, or with decreased renal function. CT images of the majority of patients with DILI by ALK‐TKIs show an OP pattern. Key points Significant findings of the study: Extra caution is needed when recommending ALK‐TKIs for patients over 64 years of age or those with decreased renal function. Computed tomography images of the majority of patients with DILI by ALK‐TKIs show an OP pattern. What this study adds: The same or a different ALK‐TKI may be considered as a treatment option after the onset of DILI, based on careful judgment.