A case report of acute hepatic and renal failure associated with savolitinib treatment in advanced lung adenocarcinoma.

Abstract

Background: Savolitinib, a novel inhibitor of mesenchymal-epithelial transition factor (MET), has demonstrated significant efficacy and an acceptable safety profile, leading to its approval in China for advanced non-small cell lung cancer (NSCLC) patients with MET exon 14 skipping alterations. Despite its therapeutic benefits, reports of severe adverse effects, including acute hepatic failure and renal failure, remain scarce. This report presents a rare case of a lung adenocarcinoma patient who developed acute hepatic and renal failure following treatment with savolitinib.

Case description: The patient was a 62-year-old woman diagnosed with advanced lung adenocarcinoma (T4N1M1a, IVa stage) with confirmed MET exon 14 skipping alterations. She initiated oral savolitinib at a dosage of 600 mg per day after diagnosis, when initial blood tests indicated normal liver and renal function. However, within a month, she began experiencing symptoms of vomiting, decreased appetite, irritability, and restlessness. These symptoms progressed, leading to her hospital admission, where acute hepatic and renal failure were diagnosed. Tests for antibodies associated with autoimmune hepatitis and viral hepatitis were negative, and liver ultrasound revealed a normal-sized liver without gallbladder or pigmented bile duct stones. Renal ultrasound showed enhanced echogenicity in the renal cortex. Unfortunately, the patient succumbed to her illness two days after admission, despite supportive measures including continuous renal replacement therapy.

Conclusions: This case underscores the importance of monitoring liver and kidney function in patients receiving savolitinib to facilitate the early detection and management of potentially fatal adverse reactions.