Drug interaction profile of TKI alectinib allows effective and safe treatment of ALK+ lung cancer in the kidney transplant recipient
Language English Country Netherlands Media print-electronic
Document type Case Reports, Journal Article
PubMed
34339964
DOI
10.1016/j.intimp.2021.108012
PII: S1567-5769(21)00648-2
Knihovny.cz E-resources
- Keywords
- ALK+ NSCLC, Alectinib, Crizotinib, Drug interaction, Kidney transplant, cyclosporine A,
- MeSH
- Anaplastic Lymphoma Kinase antagonists & inhibitors MeSH
- Protein Kinase Inhibitors pharmacology MeSH
- Carbazoles pharmacology MeSH
- Crizotinib pharmacology MeSH
- Drug Interactions MeSH
- Middle Aged MeSH
- Humans MeSH
- Lung Neoplasms drug therapy pathology MeSH
- Carcinoma, Non-Small-Cell Lung drug therapy pathology secondary MeSH
- Piperidines pharmacology MeSH
- Kidney Transplantation MeSH
- Protein-Tyrosine Kinases antagonists & inhibitors MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- Names of Substances
- alectinib MeSH Browser
- Anaplastic Lymphoma Kinase MeSH
- Protein Kinase Inhibitors MeSH
- Carbazoles MeSH
- Crizotinib MeSH
- Piperidines MeSH
- Protein-Tyrosine Kinases MeSH
ALK targeting with tyrosine kinase inhibitors (TKIs) is a highly potent treatment option for the therapy of ALK positive non-small cell lung cancer (NSCLC). However, pharmacokinetics of TKIs leads to clinically significant drug interactions, and the interfering co-medication may hamper the anti-cancer therapeutic management. Here, we present for the first time a drug interaction profile of ALK-TKIs, crizotinib and alectinib, and immunosuppressive agent cyclosporine A in kidney transplant recipients diagnosed with ALK+ lung cancer. Based on therapeutic drug monitoring of cyclosporin A plasma level, the dose of cyclosporine A has been adjusted to achieve a safe and effective therapeutic level in terms of both cancer treatment and kidney transplant condition. Particularly, 15 years upon the kidney transplantation, the stage IV lung cancer patient was treated with the 1st-line chemotherapy, the 2nd-line ALK-TKI crizotinib followed by ALK-TKI alectinib. The successful therapy with ALK-TKIs has been continuing for more than 36 months, including the period when the patient was treated for COVID-19 bilateral pneumonia. Hence, the therapy of ALK+ NSCLC with ALK-TKIs in organ transplant recipients treated with cyclosporine A may be feasible and effective.
Center of Cardiovascular and Transplant Surgery Pekarska 53 656 91 Brno the Czech Republic
Department of Nuclear Medicine Masaryk Memorial Cancer Institute 656 53 Brno the Czech Republic
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