Fulminant hepatitis following crizotinib administration for ALK-positive non-small-cell lung carcinoma

• Published in: Japanese journal of clinical oncology 2014-09, Vol.44 (9), p.872-875
• Main Authors: Sato, Yuki, Fujimoto, Daichi, Shibata, Yumi, Seo, Ryutaro, Suginoshita, Yoshiki, Imai, Yukihiro, Tomii, Keisuke
• Format: Article
• Language: English
• Subjects: Alanine Transaminase - blood; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Aspartate Aminotransferases - blood; Carcinoma, Non-Small-Cell Lung - chemistry; Carcinoma, Non-Small-Cell Lung - drug therapy; Chemical and Drug Induced Liver Injury - enzymology; Chemical and Drug Induced Liver Injury - etiology; Chemical and Drug Induced Liver Injury - therapy; Fatal Outcome; Female; Humans; Lung Neoplasms - chemistry; Lung Neoplasms - drug therapy; Middle Aged; Protein Kinase Inhibitors - administration & dosage; Protein Kinase Inhibitors - adverse effects; Pyrazoles - administration & dosage; Pyrazoles - adverse effects; Pyridines - administration & dosage; Pyridines - adverse effects; Receptor Protein-Tyrosine Kinases - analysis; Risk Factors
• ISSN: 0368-2811; 1465-3621
• DOI: 10.1093/jjco/hyu086

We herein report a case of fatal fulminant hepatitis secondary to crizotinib administration. The patient was 54-year-old female with a history of Hepatitis C infection (not current), dermatomyositis and steroid-induced diabetes mellitus. She was diagnosed with advanced lung adenocarcinoma with anaplastic lymphoma kinase rearrangement. We began 400 mg of crizotinib as first-line therapy. No adverse effects were seen until Day 16. On Day 29, she was admitted to hospital with elevated liver enzymes (aspartate aminotransferase 3236 IU/l, alanine aminotransferase 5201 IU/l) and coagulopathy (prothrombin time