Patients with high-grade alectinib-induced skin rash: How do we desensitize these patients? A case report and review of literature
With the advent of targeted therapy for non-small-cell lung cancer, there are many new available treatment options for patients whose cancer harbors an actionable mutation or alteration. These new medications come with numerous side effects, for some of which, the management is not well defined. Ale...
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doaj-6d60627e41384bc1a3b9a70c6e6213ae2020-11-25T04:02:10ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2020-10-01810.1177/2050313X20966895Patients with high-grade alectinib-induced skin rash: How do we desensitize these patients? A case report and review of literatureKaran SeegobinUmair MajeedYanyan LouYujie ZhaoRami ManochakianWith the advent of targeted therapy for non-small-cell lung cancer, there are many new available treatment options for patients whose cancer harbors an actionable mutation or alteration. These new medications come with numerous side effects, for some of which, the management is not well defined. Alectinib is a second-generation tyrosine kinase inhibitor approved for stage-IV lung adenocarcinoma with anaplastic lymphoma kinase gene rearrangement. Severe (⩾Grade 3) skin rash is a rare side effect of alectinib. Reintroducing alectinib in patients with severe skin rash is not well defined in the medical literature. While other case reports have outlined their approach and desensitization protocol, the maximum dose that patients were titrated up to in a desensitization protocol was 300 mg twice daily. Here, we report a case of Grade 3 skin rash secondary to alectinib, and our experience in managing the rash and reintroducing alectinib with a unique desensitization protocol to a max of 600 mg twice daily (full dose). This case could provide further guidance to oncologists managing patients with this adverse event and may aid in reducing concerns to both patients and physicians about recurrence of skin rash at the maximum dose.https://doi.org/10.1177/2050313X20966895 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Karan Seegobin Umair Majeed Yanyan Lou Yujie Zhao Rami Manochakian |
spellingShingle |
Karan Seegobin Umair Majeed Yanyan Lou Yujie Zhao Rami Manochakian Patients with high-grade alectinib-induced skin rash: How do we desensitize these patients? A case report and review of literature SAGE Open Medical Case Reports |
author_facet |
Karan Seegobin Umair Majeed Yanyan Lou Yujie Zhao Rami Manochakian |
author_sort |
Karan Seegobin |
title |
Patients with high-grade alectinib-induced skin rash: How do we desensitize these patients? A case report and review of literature |
title_short |
Patients with high-grade alectinib-induced skin rash: How do we desensitize these patients? A case report and review of literature |
title_full |
Patients with high-grade alectinib-induced skin rash: How do we desensitize these patients? A case report and review of literature |
title_fullStr |
Patients with high-grade alectinib-induced skin rash: How do we desensitize these patients? A case report and review of literature |
title_full_unstemmed |
Patients with high-grade alectinib-induced skin rash: How do we desensitize these patients? A case report and review of literature |
title_sort |
patients with high-grade alectinib-induced skin rash: how do we desensitize these patients? a case report and review of literature |
publisher |
SAGE Publishing |
series |
SAGE Open Medical Case Reports |
issn |
2050-313X |
publishDate |
2020-10-01 |
description |
With the advent of targeted therapy for non-small-cell lung cancer, there are many new available treatment options for patients whose cancer harbors an actionable mutation or alteration. These new medications come with numerous side effects, for some of which, the management is not well defined. Alectinib is a second-generation tyrosine kinase inhibitor approved for stage-IV lung adenocarcinoma with anaplastic lymphoma kinase gene rearrangement. Severe (⩾Grade 3) skin rash is a rare side effect of alectinib. Reintroducing alectinib in patients with severe skin rash is not well defined in the medical literature. While other case reports have outlined their approach and desensitization protocol, the maximum dose that patients were titrated up to in a desensitization protocol was 300 mg twice daily. Here, we report a case of Grade 3 skin rash secondary to alectinib, and our experience in managing the rash and reintroducing alectinib with a unique desensitization protocol to a max of 600 mg twice daily (full dose). This case could provide further guidance to oncologists managing patients with this adverse event and may aid in reducing concerns to both patients and physicians about recurrence of skin rash at the maximum dose. |
url |
https://doi.org/10.1177/2050313X20966895 |
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