Crizotinib-induced fatal fulminant liver failure
Robin M J M van Geel1, Jeroen J M A Hendrikx2, Jelmer E Vahl3
1Department of Clinical Pharmacology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Lung Cancer (Amsterdam, Netherlands)
|February 23, 2016
Summary
Crizotinib, a targeted therapy for non-small-cell lung cancer, can cause severe liver injury. This case highlights the critical risk of acute liver failure associated with crizotinib treatment.
Area of Science:
- Oncology
- Hepatology
- Pharmacology
Background:
- Non-small-cell lung cancer (NSCLC) treatment has advanced with targeted therapies.
- Crizotinib is an anaplastic lymphoma kinase (ALK) inhibitor used for ALK-positive NSCLC.
- Drug-induced liver injury (DILI) is a potential adverse effect of cancer therapeutics.
Observation:
- A 62-year-old female with NSCLC received crizotinib therapy.
- Within 24 days, she developed acute liver failure.
- Laboratory values showed marked elevations in liver enzymes and bilirubin, with prolonged PT-INR.
Findings:
- The patient exhibited symptoms of hepatic encephalopathy and hepatorenal syndrome.
- Liver enzyme levels (AST, ALT) increased dramatically.
- Massive liver cell necrosis was confirmed as the cause of death.
Implications:
- Crizotinib can precipitate acute liver failure in NSCLC patients.
- Close monitoring of liver function is crucial during crizotinib treatment.
- This case underscores the need for vigilance regarding severe hepatotoxicity from targeted cancer therapies.
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