Even though tyrosine kinase inhibitors (TKI) improve survival in non-small cell lung cancer (NSCLC), it is related to the risk of drug-induced pneumonitis. Whilst little is known regarding TKI-induced pneumonitis, adverse reactions carry a significant mortality rate and impact the available treatment options. Here, we present a case of an elderly gentleman diagnosed with metastatic ALK-positive NSCLC, who initially experienced ceritinib-induced skin vasculitis and subsequently developed acute respiratory distress syndrome upon being re-challenged with ceritinib. The patient’s clinical and radiological condition showed improvement after initiating intravenous methylprednisolone and discontinuing the targeted therapy. Ceritinib-associated pneumonitis represents a rare form of pulmonary toxicity, emphasising the importance of early identification and intervention to mitigate mortality risk.
Cite this paper
Ng, B. H. , Low, H. J. , Abeed, N. N. N. , Sharil, N. S. , Osman, R. A. , Azmi, M. I. , Eezamuddeen, M. and Ban, A. Y. (2024). Ceritinib-Induced Organising Pneumonitis. Open Access Library Journal, 11, e2075. doi: http://dx.doi.org/10.4236/oalib.1112075.
Wu, Y., Shi, Y., Tan, D.S.W., Xiaoqing, L., Cheng, Y., Zhou, J., et al. (2020) Phase 1/2 Study of Ceritinib in Chinese Patients with Advanced Anaplastic Lymphoma Kinase-Rearranged Non-Small Cell Lung Cancer Previously Treated with Crizotinib: Results from ASCEND-6. Lung Cancer, 150, 240-246. https://doi.org/10.1016/j.lungcan.2020.10.024
Ono, A., Takahashi, T., Oishi, T., Sugino, T., Akamatsu, H., Shukuya, T., et al. (2013) Acute Lung Injury with Alveolar Hemorrhage as Adverse Drug Reaction Related to Crizotinib. Journal of Clinical Oncology, 31, e417-e419. https://doi.org/10.1200/jco.2012.47.1110
Asai, N., Yamaguchi, E. and Kubo, A. (2014) Successful Crizotinib Rechallenge after Crizotinib-Induced Interstitial Lung Disease in Patients with Advanced Non-Small-Cell Lung Cancer. Clinical Lung Cancer, 15, e33-e35. https://doi.org/10.1016/j.cllc.2013.12.004
Yanagisawa, S., Inoue, A., Koarai, A., Ono, M., Tamai, T. and Ichinose, M. (2013) Successful Crizotinib Retreatment After Crizotinib-Induced Interstitial Lung Disease. Journal of Thoracic Oncology, 8, e73-e74. https://doi.org/10.1097/jto.0b013e318293dfc1
Dy, G.K. and Adjei, A.A. (2013) Under-standing, Recognizing, and Managing Toxicities of Targeted Anticancer Therapies. CA: A Cancer Journal for Clinicians, 63, 249-279. https://doi.org/10.3322/caac.21184
Suh, C.H., Kim, K.W., Pyo, J., Hatabu, H. and Nishino, M. (2019) The Incidence of ALK Inhibitor-Related Pneumonitis in Advanced Non-Small-Cell Lung Cancer Patients: A Systematic Review and Meta-Analysis. Lung Cancer, 132, 79-86. https://doi.org/10.1016/j.lungcan.2019.04.015
Qie, W., Zhao, Q., Yang, L., Zou, B., Duan, Y., Yao, Y., et al. (2023) Incidence of Pneumonitis Following the Use of Different Anaplastic Lymphoma Ki-nase Tyrosine Kinase Inhibitor Regimens: An Updated Systematic Review and Meta-Analysis. Cancer Medicine, 12, 13873-13884. https://doi.org/10.1002/cam4.5913
Pellegrino, B., Facchinetti, F., Bordi, P., Silva, M., Gnetti, L. and Tiseo, M. (2018) Lung Toxicity in Non-Small-Cell Lung Cancer Patients Exposed to ALK Inhibitors: Report of a Peculiar Case and Systematic Review of the Literature. Clinical Lung Cancer, 19, e151-e161. https://doi.org/10.1016/j.cllc.2017.10.008
Min, J.H., Lee, H.Y., Lim, H., Ahn, M., Park, K., Chung, M.P., et al. (2011) Drug-Induced Interstitial Lung Disease in Tyrosine Kinase Inhibitor Therapy for Non-Small Cell Lung Cancer: A Review on Current Insight. Cancer Chemotherapy and Pharmacology, 68, 1099-1109. https://doi.org/10.1007/s00280-011-1737-2
Gou, X., Yuan, C., Bai, Y., Shi, L., Xing, S. and Ma, H. (2021) Pneumonia Caused by Crizotinib: Case Report and Review of Literature. Annals of Palliative Medicine, 10, 4932-4937. https://doi.org/10.21037/apm-19-420
