Drug interaction profile of TKI alectinib allows effective and safe treatment of ALK+ lung cancer in the kidney transplant recipient
Jazyk angličtina Země Nizozemsko Médium print-electronic
Typ dokumentu kazuistiky, časopisecké články
PubMed
34339964
DOI
10.1016/j.intimp.2021.108012
PII: S1567-5769(21)00648-2
Knihovny.cz E-zdroje
- Klíčová slova
- ALK+ NSCLC, Alectinib, Crizotinib, Drug interaction, Kidney transplant, cyclosporine A,
- MeSH
- anaplastická lymfomová kináza antagonisté a inhibitory MeSH
- inhibitory proteinkinas farmakologie MeSH
- karbazoly farmakologie MeSH
- krizotinib farmakologie MeSH
- lékové interakce MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory plic farmakoterapie patologie MeSH
- nemalobuněčný karcinom plic farmakoterapie patologie sekundární MeSH
- piperidiny farmakologie MeSH
- transplantace ledvin MeSH
- tyrosinkinasy antagonisté a inhibitory MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- alectinib MeSH Prohlížeč
- anaplastická lymfomová kináza MeSH
- inhibitory proteinkinas MeSH
- karbazoly MeSH
- krizotinib MeSH
- piperidiny MeSH
- tyrosinkinasy 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.
