Alectinib - induced acute renal failure
Elena Prado-Mel1, Pablo Ciudad-Gutiérrez1, Almudena Sánchez-Martín2
1Hospital Pharmacy Department, Virgen del Rocío Hospital, Seville, Spain.
Summary
Alectinib, used for anaplastic lymphoma kinase-positive non-small cell lung cancer, can cause acute kidney injury. This case highlights a patient who developed acute interstitial nephritis and acute tubular necrosis, requiring dialysis and treatment adjustment.
Area of Science:
- Oncology
- Nephrology
- Pharmacology
Background:
- Alectinib is a targeted therapy for anaplastic lymphoma kinase-positive non-small cell lung cancer.
- It is known for a generally favorable safety profile compared to other anaplastic lymphoma kinase inhibitors.
- Acute kidney injury is a rare but potential adverse effect.
Purpose of the Study:
- To report a case of acute interstitial nephritis and acute tubular necrosis associated with alectinib therapy.
- To emphasize the importance of monitoring renal function in patients receiving alectinib.
- To discuss the management and outcomes of drug-induced kidney injury.
Main Methods:
- Case report of a 68-year-old male with advanced non-small cell lung cancer.
- Clinical presentation of nausea, vomiting, and dyspnea following alectinib initiation.
- Laboratory tests revealed acute renal failure; renal biopsy confirmed acute interstitial nephritis and acute tubular necrosis.
Main Results:
- The patient developed acute kidney injury, necessitating hemodialysis.
- Renal function improved with corticosteroid treatment after discontinuation of alectinib.
- Alectinib was switched to lorlatinib, with stable renal function observed at 10-month follow-up.
Conclusions:
- Alectinib was deemed the probable cause of acute kidney injury in this patient.
- Close monitoring of renal function is recommended for patients treated with alectinib.
- Drug-induced kidney injury, though infrequent, requires prompt recognition and management.
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