<p>Alectinib Induced Regression of Renal and Hepatic Cysts Caused by Crizotinib</p>

Abstract

Background: Crizotinib is the first tyrosine kinase inhibitor approved for the treatment of anaplastic lymphoma kinase (ALK) rearranged non-small cell lung cancer (NSCLC). An increased incidence of renal cysts has been described during the crizotinib treatment. Case Presentation: We herein report the case of a 74-year-old woman who received crizotinib for metastatic ALK-positive NSCLC. During the crizotinib treatment, complex renal cystic lesions with invasion of perirenal spaces and iliopsoas muscle appeared; two complex hepatic cysts were also observed. Almost all lesions disappeared after switching to alectinib, a second-generation ALK inhibitor. Conclusion: It would seem that alectinib is able to reduce in size and number hepatic and renal cysts caused by the crizotinib treatment. Nevertheless, further studies are needed to clarify the role of both crizotinib in the onset of renal and hepatic cysts and alectinib in their disappearance.

Development of crizotinib-associated renal cyst in a non-small cell lung cancer patient with ALK fusion: a case report and review of the literature

“…Majority of CARCs are spontaneously regressed dramatically or completely after discontinuation of crizotinib or switching to 2nd generation of ALK inhibitor, alectinib [ 32 , 33 ]. Consistently, in the current case report, CARC was dramatically regressed two months after stopping crizotinib, and furthermore, cystic lesions in both kidneys and liver did not re-occur or progressed after switching to alectinib.…”

“…Consistently, in the current case report, CARC was dramatically regressed two months after stopping crizotinib, and furthermore, cystic lesions in both kidneys and liver did not re-occur or progressed after switching to alectinib. Interestingly, Marino et al have recently reported that alectinib could induce rapid regression of renal and hepatic cysts caused by crizotinib [ 32 ]. Similarly, Taima et al reported that, 17 months after switching crizotinib to alectinib, not only CARC was significantly regressed, but also the hypoproteinemia and systemic inflammation were significantly improved [ 33 ].…”