Crizotinib-induced osteitis mimicking bone metastasis in a stage IV ALK-rearranged NSCLC patient: a case report.
Adult
Anaplastic Lymphoma Kinase
/ antagonists & inhibitors
Antineoplastic Agents
/ adverse effects
Bone Neoplasms
/ diagnosis
Carcinoma, Non-Small-Cell Lung
/ complications
Crizotinib
/ adverse effects
Female
Humans
Lung Neoplasms
/ complications
Osteitis
/ chemically induced
Protein Kinase Inhibitors
/ adverse effects
Pyrimidines
/ pharmacology
Sulfones
/ pharmacology
Tomography, X-Ray Computed
ALK inhibitors
ALK-rearranged NSCLC
Ceritinib
Crizotinib
Drug toxicity
Osteitis
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
06 Jan 2020
06 Jan 2020
Historique:
received:
08
03
2019
accepted:
20
12
2019
entrez:
8
1
2020
pubmed:
8
1
2020
medline:
17
6
2020
Statut:
epublish
Résumé
Targeted therapies are a standard of care for first-line treatment of Anaplastic lymphoma kinase (ALK)-rearranged non small cell lung cancer (NSCLC). Giving the rapid pace of drug discovery and development in this area, reporting of adverse effects of ALK inhibitors is crucial. Here, we report a case of osteitis induced by an ALK inhibitor mimicking bone metastasis, a previously undescribed side effect of crizotinib. A 31-year-old woman with stage IV ALK-rearranged NSCLC presented with back pain after 3 months of crizotinib treatment. Diagnostic work-up showed osteitis on the 4th and 5th thoracic vertebrae, anterior soft tissue infiltration and epiduritis, without any sign of infection. Spinal cord decompression, histological removal and osteosynthesis were performed. Histologic examination showed necrosis with abundant peripheral neutrophils, no microorganism nor malignant cell. Symptoms and Computarized Tomography-abnormalities rapidly diseappeared after crizotinib withdrawal and did not recur after ceritinib onset. This is the first report of crizotinib-induced osteitis. Crizotinib differs from other ALK inhibitors as it targets other kinases as well, which may have been responsible for the osteitis. Crizotinib can induce rapidly extensive osteitis, which can mimic tumor progression.
Sections du résumé
BACKGROUND
BACKGROUND
Targeted therapies are a standard of care for first-line treatment of Anaplastic lymphoma kinase (ALK)-rearranged non small cell lung cancer (NSCLC). Giving the rapid pace of drug discovery and development in this area, reporting of adverse effects of ALK inhibitors is crucial. Here, we report a case of osteitis induced by an ALK inhibitor mimicking bone metastasis, a previously undescribed side effect of crizotinib.
CASE PRESENTATION
METHODS
A 31-year-old woman with stage IV ALK-rearranged NSCLC presented with back pain after 3 months of crizotinib treatment. Diagnostic work-up showed osteitis on the 4th and 5th thoracic vertebrae, anterior soft tissue infiltration and epiduritis, without any sign of infection. Spinal cord decompression, histological removal and osteosynthesis were performed. Histologic examination showed necrosis with abundant peripheral neutrophils, no microorganism nor malignant cell. Symptoms and Computarized Tomography-abnormalities rapidly diseappeared after crizotinib withdrawal and did not recur after ceritinib onset.
CONCLUSIONS
CONCLUSIONS
This is the first report of crizotinib-induced osteitis. Crizotinib differs from other ALK inhibitors as it targets other kinases as well, which may have been responsible for the osteitis. Crizotinib can induce rapidly extensive osteitis, which can mimic tumor progression.
Identifiants
pubmed: 31906956
doi: 10.1186/s12885-019-6486-3
pii: 10.1186/s12885-019-6486-3
pmc: PMC6945627
doi:
Substances chimiques
Antineoplastic Agents
0
Protein Kinase Inhibitors
0
Pyrimidines
0
Sulfones
0
Crizotinib
53AH36668S
ALK protein, human
EC 2.7.10.1
Anaplastic Lymphoma Kinase
EC 2.7.10.1
ceritinib
K418KG2GET
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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