Hyperbilirubinemia in a Patient Receiving Alectinib for Anaplastic Lymphoma Kinase Positive Non-Small-Cell Lung Cancer: A Histological Features.

IF 2.7 4区医学 Q3 BIOTECHNOLOGY & APPLIED MICROBIOLOGY

OncoTargets and therapy Pub Date : 2024-12-11 eCollection Date: 2024-01-01 DOI:10.2147/OTT.S486860

Qian Zhang, Lei Yan, Yujie Bao, Xiaoling Yuan, Donglin Yin, Jie Xu

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引用次数: 0

Abstract

Background: Alectinib is a second generation of anaplastic lymphoma kinase (ALK) inhibitor that has been approved for the treatment of advanced non-small-cell lung cancer (NSCLC) with ALK rearrangements. Hepatotoxicity is the most common adverse drug reaction. However, there is currently no published report on the pathologic findings of alectinib-induced hyperbilirubinemia.

Case presentation: Here, we report a case of a patient with NSCLC and chronic hepatitis B (CHB) who was treated with alectinib and developed grade 4 hyperbilirubinemia after 3 years on therapy. Alectinib was discontinued, and an artificial liver support system (ALSS) was used to decline blood bilirubin levels. The pathological manifestations from a liver biopsy showed the hepatocytes with scattered focal necrosis, bile stasis, and vesicular steatosis, bile emboli in capillaries, and star-shaped fibers proliferation in the portal area.

Conclusion: This is the first report of alectinib-induced hyperbilirubinemia which was confirmed by liver histopathology and successfully relieved by ALSS treatment and drug discontinuation.

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接受阿来替尼治疗淋巴瘤激酶阳性非小细胞肺癌患者的高胆红素血症：组织学特征

背景：阿埃替尼是第二代无性淋巴瘤激酶（ALK）抑制剂：阿来替尼是第二代无性淋巴瘤激酶（ALK）抑制剂，已被批准用于治疗ALK重排的晚期非小细胞肺癌（NSCLC）。肝毒性是最常见的药物不良反应。然而，目前还没有关于阿来替尼诱发高胆红素血症病理结果的公开报道：在此，我们报告了一例 NSCLC 和慢性乙型肝炎（CHB）患者的病例，该患者接受了阿来替尼治疗，并在治疗 3 年后出现了 4 级高胆红素血症。患者停用了阿来替尼，并使用人工肝支持系统（ALSS）来降低血胆红素水平。肝活检的病理表现为肝细胞散在灶性坏死、胆汁淤积和泡状脂肪变性，毛细血管内有胆汁栓塞，肝门区有星形纤维增生：这是首次报道阿来替尼诱导的高胆红素血症，肝组织病理学证实了该病症，并通过ALSS治疗和停药成功缓解了该病症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

OncoTargets and therapy BIOTECHNOLOGY & APPLIED MICROBIOLOGY-ONCOLOGY

CiteScore

9.70

自引率

0.00%

发文量

221

审稿时长

1 months

期刊介绍： OncoTargets and Therapy is an international, peer-reviewed journal focusing on molecular aspects of cancer research, that is, the molecular diagnosis of and targeted molecular or precision therapy for all types of cancer. The journal is characterized by the rapid reporting of high-quality original research, basic science, reviews and evaluations, expert opinion and commentary that shed novel insight on a cancer or cancer subtype. Specific topics covered by the journal include: -Novel therapeutic targets and innovative agents -Novel therapeutic regimens for improved benefit and/or decreased side effects -Early stage clinical trials Further considerations when submitting to OncoTargets and Therapy: -Studies containing in vivo animal model data will be considered favorably. -Tissue microarray analyses will not be considered except in cases where they are supported by comprehensive biological studies involving multiple cell lines. -Biomarker association studies will be considered only when validated by comprehensive in vitro data and analysis of human tissue samples. -Studies utilizing publicly available data (e.g. GWAS/TCGA/GEO etc.) should add to the body of knowledge about a specific disease or relevant phenotype and must be validated using the authors’ own data through replication in an independent sample set and functional follow-up. -Bioinformatics studies must be validated using the authors’ own data through replication in an independent sample set and functional follow-up. -Single nucleotide polymorphism (SNP) studies will not be considered.