Successful Treatment of Crizotinib-Induced Fulminant Liver Failure: A Case Report and Review of Literature

Kreitman, Kyle; Nair, Satheesh; Kothadia, Jiten P.

doi:10.1155/2020/8247960

Cited by 9 publications

(10 citation statements)

References 23 publications

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“…Regarding overcoming ALK-TKI-induced hepatotoxicity, several cases have been reported, especially for crizotinib [9, 14]. In one such report, the majority of the liver damage was of the hepatocellular type, and crizotinib was successfully resumed later at a lower dose (100 mg/day) [14].…”

Section: Discussionmentioning

confidence: 99%

“…Alectinib exhibits a lower frequency of hepatotoxicity than crizotinib or ceritinib [6, 7], accounting for fewer reports of alectinib-induced severe liver damage [8]. Although several cases have been reported where crizotinib-induced hepatotoxicity was treated [9], there are no established strategies to overcome the hepatotoxicity of ALK-TKIs, especially alectinib.…”

Section: Introductionmentioning

confidence: 99%

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Successful Treatment with Lorlatinib after the Development of Alectinib-Induced Liver Damage in ALK-Positive Non-Small-Cell Lung Cancer: A Case Report

Makimoto¹,

Kawakado²,

Nakanishi³

et al. 2021

Case Rep Oncol

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Alectinib is a key drug for treating anaplastic lymphoma kinase (ALK)-positive non-small-cell lung cancer (NSCLC). Alectinib-induced hepatotoxicity is less common than that through other ALK inhibitors, such as crizotinib or ceritinib. Herein, we describe a case of ALK-positive adenocarcinoma successfully treated with lorlatinib after developing alectinib-induced hepatotoxicity. A 57-year-old Japanese man received alectinib as first-line therapy for ALK-positive NSCLC. After 79 days, alectinib was discontinued because of hepatotoxicity and later restarted at 150 mg/day, inducing hepatotoxicity again after 64 days. Switching to lorlatinib treatment (continued for >4 months) caused no severe adverse effects. Hence, lorlatinib may be useful for patients experiencing alectinib-induced hepatotoxicity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Successful Treatment with Lorlatinib after the Development of Alectinib-Induced Liver Damage in ALK-Positive Non-Small-Cell Lung Cancer: A Case Report

Makimoto¹,

Kawakado²,

Nakanishi³

et al. 2021

Case Rep Oncol

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“…Other than treatment with intravenous N-acetylcysteine (NAC), there have been few other options for improving transplant-free survival in non-acetaminophen acute liver failure. There were several reports of the use of NAC to treat DILI published over the last year [186,187]. Notably, we found a randomized controlled trial that evaluated the use of NAC for anti-TB-DILI [186].…”

Section: Updates In Treatment and Preventionmentioning

confidence: 92%

“…Its results showed that although NAC did not shorten the time to ALT < 100 U/L in participants with anti-TB-DILI, it did significantly reduce the length of a hospital stay from 18 days to 9 days compared with placebo. A case report described using NAC to treat a 46-year-old female patient with non-small cell lung cancer who developed acute liver failure with a MELD of 39 while receiving crizotinib [187]. Her course improved after discontinuation of the chemotherapy and administration of NAC for 7 days.…”

Section: Updates In Treatment and Preventionmentioning

confidence: 99%

Drug-Induced Liver Injury: Highlights and Controversies in the Recent Literature

et al. 2021

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Drug-induced liver injury (DILI) remains an important, yet challenging diagnosis for physicians. Each year, additional drugs are implicated in DILI and this year was no different, with more than 1400 articles published on the subject. This review examines some of the most significant highlights and controversies in DILI-related research over the past year and their implications for clinical practice. Several new drugs were approved by the US Food and Drug Administration including a number of drugs implicated in causing DILI, particularly among the chemotherapeutic classes. The COVID-19 pandemic was also a major focus of attention in 2020 and we discuss some of the notable aspects of COVID-19-related liver injury and its implications for diagnosing DILI. Updates in diagnostic and causality assessments related to DILI such as the Roussel Uclaf Causality Assessment Method are included, mindful that there is still no single biomarker or diagnostic tool to unequivocally diagnose DILI. Glutamate dehydrogenase received renewed attention as being more specific than alanine aminotransferase. There were a few new reports of previously unrecognized hepatotoxins, including immune modulators and novel gene therapy drugs that we highlight. Updates and new developments of previously described hepatotoxins, such as immune checkpoint inhibitors and anti-tuberculosis drugs are reviewed. Finally, novel technologies such as organoid culture systems to better predict DILI preclinically may be coming of age and determinants of hepatocyte loss, such as calculating P ALT are poised to improve our current means of estimating DILI severity and the risk of acute liver failure.

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“…However, previous studies showed an increased risk of all‐grade stomatitis, skin rash, diarrhoea, nausea and elevated transaminases 8,9 . More than that, cases of hepatic failure caused by crizotinib have gradually increased, usually resulting in high lethality 10,11 . For overcoming the crizotinib‐caused resistance and intolerance, second‐ and third‐generation ALK TKIs including alectinib, brigatinib, ceritinib and lorlatinib were developed and applied clinically in recent years 12‐14 .…”

Section: What Is Known and Objectivementioning

confidence: 99%

Anaplastic lymphoma kinase tyrosine kinase inhibitor‐induced hepatic failure in lung cancer patients: A study of signal mining and analysis of the FDA adverse event reporting system database

et al. 2021

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What is known and Objective. Anaplastic Lymphoma Kinase Tyrosine Kinase Inhibitors (ALK TKIs) are standard first‐line therapy for non‐small cell lung cancer patients with ALK rearrangement. Although some cases of hepatotoxicity related to these drugs have been reported, there is still a lack of investigation on severe hepatotoxicity, such as hepatic failure, with ALK TKIs. Methods We evaluated ALK TKI (crizotinib, alectinib, brigatinib, ceritinib and lorlatinib)‐induced hepatic failure events (AIHFEs), by using the Reporting Odds Ratio (ROR) and Bayesian Confidence Propagation Neural Network method for mining the adverse event report signals in the FDA Adverse Event Reporting System (FAERS) database from Jan 2013 to Dec 2019. Results and Discussion The AIHFEs of “Hepatic failure,” “hepatitis fulminant” and “hepatic necrosis” were defined as exposure event signals caused by ALK TKIs. The RORs of “Hepatic failure” were 4.95 (2.36–10.42) in alectinib, 3.77 (1.69–8.40) in ceritinib and 2.45 (1.60–3.76) in crizotinib, respectively. The ROR of “hepatitis fulminant” was 7.86 (3.52–17.54) in crizotinib. The Information Component value of “hepatic necrosis” was 1.97 (0.15) in alectinib. In reports of exposure‐event signals, the clinical outcome of eventual death was common and could occur within 3 months. In the reports of “hepatic failure,” there was no significant difference in the number of reports between men and women [OR=1.86 (0.94–3.67), p = 0.09]. What is new and Conclusions. By mining the adverse event report signals in the FAERS database, we found the exposure event signals of AIHFEs in ALK TKIs were “hepatic failure,” “hepatitis fulminant” and “hepatic necrosis”. AIHFEs were more likely to appear in the reports of ceritinib, crizotinib and alectinib.

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Successful Treatment of Crizotinib-Induced Fulminant Liver Failure: A Case Report and Review of Literature

Cited by 9 publications

References 23 publications

Successful Treatment with Lorlatinib after the Development of Alectinib-Induced Liver Damage in ALK-Positive Non-Small-Cell Lung Cancer: A Case Report

Successful Treatment with Lorlatinib after the Development of Alectinib-Induced Liver Damage in ALK-Positive Non-Small-Cell Lung Cancer: A Case Report

Drug-Induced Liver Injury: Highlights and Controversies in the Recent Literature

Anaplastic lymphoma kinase tyrosine kinase inhibitor‐induced hepatic failure in lung cancer patients: A study of signal mining and analysis of the FDA adverse event reporting system database

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