Acute kidney injury following crizotinib administration for non-small-cell lung carcinoma

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• 作者：Lauris Gastaud ; Damien Ambrosetti ; Josiane Otto ; Charles-Hugo Marquette ; Michael Coutts ; Paul Hofman ; Vincent Esnault ; Guillaume Favre
• 关键词：Crizotinib ; Tyrosine kinase inhibitor ; Chemotherapy ; Acute tubular necrosis ; Acute kidney injury ; Adverse drug reaction ; Non-small-cell lung carcinoma ; EML4-ALK protein
• 刊名：Lung Cancer
• 出版年：November, 2013
• 年：2013
• 卷：82
• 期：2
• 页码：362-364
• 全文大小：1139 K

文摘

A case of locally advanced non-small-cell lung carcinoma (NSCLC) was inadequately controlled with cisplatin, bevacizumab and pemetrexed chemotherapy. Following identification of a mutation of the echinoderm microtubule-associated protein like 4-anaplastic lymphoma kinase (EML4-ALK) gene, crizotinib was then administered as targeted treatment. Kidney function was normal at diagnosis and during the first line therapy. The administration of crizotinib coincided on two occasions with a conspicuous rise in the serum creatinine level. Urinary protein over creatinine ratio was 0.31 g/g with 22% albumin and macroscopic hematuria. A kidney biopsy was performed at the time of the second episode of renal impairment which showed acute tubular necrosis (ATN) indicating recent renal injury together with a mononuclear cell infiltrate consistent with ongoing repair related to a previous insult. The renal lesions were closely related temporally to crizotinib administration, supporting a causative role for crizotinib in the acute renal injury and this phenomenon has not previously been described.