Alectinib-Induced Pleural and Pericardial Effusions in ALK-Positive NSCLC

Alectinib is the first-line targeted treatment for advanced ALK-positive non-small-cell lung cancer. Although it has a relatively mild toxicity profile, adverse events (AEs) do occur. We present a case of alectinib-induced bilateral pleural effusions and pericardial effusion that has not previously...

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Main Authors: Maiken Parm Ulhoi, Boe Sandahl Sorensen, Peter Meldgaard
Format: Article
Language:English
Published: Karger Publishers 2021-09-01
Series:Case Reports in Oncology
Subjects:
Online Access:https://www.karger.com/Article/FullText/518081
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spelling doaj-eaabbf6bfe18449eb5367df6e94ada0f2021-10-07T13:44:28ZengKarger PublishersCase Reports in Oncology1662-65752021-09-011431323132710.1159/000518081518081Alectinib-Induced Pleural and Pericardial Effusions in ALK-Positive NSCLCMaiken Parm Ulhoi0https://orcid.org/0000-0001-6482-8139Boe Sandahl Sorensen1Peter Meldgaard2Department of Oncology, Aarhus University Hospital, Aarhus, DenmarkDepartment of Clinical Biochemistry, Aarhus University Hospital, Aarhus, DenmarkDepartment of Oncology, Aarhus University Hospital, Aarhus, DenmarkAlectinib is the first-line targeted treatment for advanced ALK-positive non-small-cell lung cancer. Although it has a relatively mild toxicity profile, adverse events (AEs) do occur. We present a case of alectinib-induced bilateral pleural effusions and pericardial effusion that has not previously been reported. The patient developed severe dyspnea 3 months after starting alectinib. He underwent thorough clinical examination including evaluations of heart function. The heart function was normal. There was no sign of pneumonitis or progressive disease on the CT scans. Cytology samples of the pleural fluid from multiple thoracocenteses were examined and showed no malignant cells. Next-generation sequencing (NGS) analysis of circulating tumor DNA from sequential blood samples was also carried out. NGS identified no known driver mutations associated with the effusions. Hence, the effusions were suspected to be an alectinib-induced AE. Alectinib was withdrawn, and the patient commenced brigatinib. The effusions subsequently regressed.https://www.karger.com/Article/FullText/518081alectinibpleural effusionpericardial effusionnon-small-cell lung cancer
collection DOAJ
language English
format Article
sources DOAJ
author Maiken Parm Ulhoi
Boe Sandahl Sorensen
Peter Meldgaard
spellingShingle Maiken Parm Ulhoi
Boe Sandahl Sorensen
Peter Meldgaard
Alectinib-Induced Pleural and Pericardial Effusions in ALK-Positive NSCLC
Case Reports in Oncology
alectinib
pleural effusion
pericardial effusion
non-small-cell lung cancer
author_facet Maiken Parm Ulhoi
Boe Sandahl Sorensen
Peter Meldgaard
author_sort Maiken Parm Ulhoi
title Alectinib-Induced Pleural and Pericardial Effusions in ALK-Positive NSCLC
title_short Alectinib-Induced Pleural and Pericardial Effusions in ALK-Positive NSCLC
title_full Alectinib-Induced Pleural and Pericardial Effusions in ALK-Positive NSCLC
title_fullStr Alectinib-Induced Pleural and Pericardial Effusions in ALK-Positive NSCLC
title_full_unstemmed Alectinib-Induced Pleural and Pericardial Effusions in ALK-Positive NSCLC
title_sort alectinib-induced pleural and pericardial effusions in alk-positive nsclc
publisher Karger Publishers
series Case Reports in Oncology
issn 1662-6575
publishDate 2021-09-01
description Alectinib is the first-line targeted treatment for advanced ALK-positive non-small-cell lung cancer. Although it has a relatively mild toxicity profile, adverse events (AEs) do occur. We present a case of alectinib-induced bilateral pleural effusions and pericardial effusion that has not previously been reported. The patient developed severe dyspnea 3 months after starting alectinib. He underwent thorough clinical examination including evaluations of heart function. The heart function was normal. There was no sign of pneumonitis or progressive disease on the CT scans. Cytology samples of the pleural fluid from multiple thoracocenteses were examined and showed no malignant cells. Next-generation sequencing (NGS) analysis of circulating tumor DNA from sequential blood samples was also carried out. NGS identified no known driver mutations associated with the effusions. Hence, the effusions were suspected to be an alectinib-induced AE. Alectinib was withdrawn, and the patient commenced brigatinib. The effusions subsequently regressed.
topic alectinib
pleural effusion
pericardial effusion
non-small-cell lung cancer
url https://www.karger.com/Article/FullText/518081
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