Effective Crizotinib schedule for an elderly patient with ALK rearranged non-small-cell lung cancer: a case report

Last Updated on March 8, 2016 by Fukuizumi A, Miyanaga A, Seike M, Kato Y, Nakamichi S, Chubachi K, Matsumoto M, Noro R, Minegishi Y, Kunugi S, Kubota K, Gemma A

Fukuizumi A, Miyanaga A, Seike M, Kato Y, Nakamichi S, Chubachi K, Matsumoto M, Noro R, Minegishi Y, Kunugi S, Kubota K, Gemma A

BMC Res Notes 2015;8:165

PMID: 25899913

Abstract

BACKGROUND: Non-small-cell lung cancers (NSCLCs) harboring translocations in anaplastic lymphoma kinase (ALK) are highly sensitive to small-molecule ALK kinase inhibitors, such as crizotinib.

CASE PRESENTATION: We describe a case of post-operative local recurrence of lung adenocarcinoma in an 81 year-old male. He underwent radiation and received chemotherapy with docetaxel, but neither treatment regimen was effective. Following identification of ALK rearrangements, crizotinib treatment was initiated. After treatment with crizotinib for 5 days, adverse events including acute renal failure (grade 2/CTCAE ver4.0) and congestive heart failure (grade 3) occurred. Crizotinib modified treatment was required. Half dose of crizotinib treatment could not control tumor progression. Ultimately, crizotinib was administrated at a dose of 250 mg twice daily every 3 day dosing for 13 months with maintenance of the anti-tumor effect.

CONCLUSION: This is the first case report that skip schedule was more effective than dose reduction daily in crizotinib administration for ALK rearranged NSCLC patient with severe adverse events.

Ph.D.; Professor in Pharmacology and Toxicology. Senior expert in theragenomic and personalized medicine and individualized drug safety. Senior expert in pharmaco- and toxicogenetics. Senior expert in human safety of drugs, chemicals, environmental pollutants, and dietary ingredients.

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