Brigatinib-induced tuberculosis reactivation: A case report

Area of Science:

• Oncology
• Pharmacology
• Immunology

Background:

• Brigatinib is a third-generation tyrosine kinase inhibitor for anaplastic lymphoma kinase (ALK) rearrangement-positive non-small cell lung cancer (NSCLC).
• It demonstrates potent anti-tumor effects, including on brain metastases, and is used in various lines of treatment.
• While generally well-tolerated, data on brigatinib's effects on the immune system, particularly lymphopenia, are limited.

Observation:

• This report describes a patient with metastatic NSCLC receiving third-line brigatinib.
• The patient experienced a reactivation of tuberculosis.
• The patient achieved a partial response to brigatinib treatment.

Findings:

• Brigatinib-induced Grade 3-4 lymphopenia is a potential serious adverse effect.
• Tuberculosis reactivation can occur in patients treated with brigatinib.
• Brigatinib demonstrated a partial anti-tumor response in this metastatic NSCLC patient.

Implications:

• Further research is needed to understand brigatinib's impact on the immune system.
• Clinicians should monitor for opportunistic infections like tuberculosis in patients on brigatinib.
• This case highlights the importance of considering immune-related adverse events with targeted cancer therapies.