Crizotinib-induced hyperlipidemia in advanced lung adenocarcinoma: A case report and literature review
1Department of Respiratory and Critical Care Medicine, Shanghai Public Health Clinical Center, Shanghai, China.
Rationale:
Crizotinib is a multi-target small molecule tyrosine kinase inhibitor that specifically targets anaplastic lymphoma kinase, mesenchymal-epithelial transition factor/hepatocyte growth factor receptor, and c-ROS oncogene 1 (ROS1). Its primary application in clinical settings is for the treatment of advanced non-small-cell lung cancer characterized by anaplastic lymphoma kinase-positive and/or ROS1 fusion gene-positive status. Hyperlipidemia is a rarely documented adverse reaction to crizotinib, with its underlying mechanisms and clinical management strategies remaining unclear.
Patient Concerns:
Significant dyslipidemia was observed in a 70-year-old female with advanced, ROS1 fusion-positive lung adenocarcinoma during crizotinib therapy.
Diagnoses:
This case report presents a patient diagnosed with advanced lung adenocarcinoma harboring an ROS1 fusion gene, who subsequently developed severe hyperlipidemia during treatment with the targeted agent crizotinib.
Interventions:
A combined strategy of crizotinib dose reduction and concomitant lipid-lowering therapy was initiated to address the hyperlipidemia, aiming to maintain control of the primary malignancy while managing the adverse effect.
Outcomes:
Following a reduction in the dosage of crizotinib and the implementation of proactive lipid-lowering interventions, both the malignancy and the associated adverse effects were effectively controlled.
Lessons:
The condition exhibited a typical positive rechallenge feature of "discontinuation and recurrence," providing critical clinical evidence to establish this causal relationship. The case aims to enhance the understanding of crizotinib's metabolic side effects, underscores the importance of dynamic lipid monitoring, and offers empirical support for the standardized management of such rare adverse reactions.
Insights
Crizotinib treatment for ROS1-positive lung cancer can cause hyperlipidemia. Dose reduction and lipid-lowering therapy effectively managed this rare side effect in a patient.
Area of Science:
- Oncology
- Pharmacology
- Medical Case Reports
Background:
- Crizotinib is a tyrosine kinase inhibitor used for advanced non-small-cell lung cancer (NSCLC) with ALK or ROS1 alterations.
- Hyperlipidemia is a rare adverse effect of crizotinib, with unclear mechanisms and management.
Purpose of the Study:
- To report a case of severe hyperlipidemia in a patient treated with crizotinib for ROS1-positive lung adenocarcinoma.
- To discuss the management of this rare adverse reaction and its implications for clinical practice.
Main Methods:
- A 70-year-old female with advanced ROS1-positive lung adenocarcinoma received crizotinib therapy.
- The patient developed significant hyperlipidemia during treatment.
- Management involved crizotinib dose reduction and lipid-lowering medication.
Main Results:
- The combined intervention successfully controlled both hyperlipidemia and the primary lung cancer.
- The adverse event showed a clear rechallenge pattern, confirming the causal link to crizotinib.
Conclusions:
- This case highlights the importance of monitoring lipid profiles in patients receiving crizotinib.
- It provides evidence for a management strategy involving dose adjustment and lipid-lowering agents for crizotinib-induced hyperlipidemia.
- Understanding and managing crizotinib's metabolic side effects is crucial for patient care.
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