Severe, reversible alectinib-induced acute kidney injury requiring dialysis in an elderly patient with metastatic non-small cell lung cancer.
Rita Rosa, Telma Sequeira, Sofia Lérias et al.
✦ AI-curated · Sources linked
Case in brief
An elderly patient with advanced ALK-rearranged non-small cell lung cancer developed severe acute kidney injury requiring dialysis shortly after starting alectinib. Renal function improved upon discontinuation of the drug but worsened again upon rechallenge, confirming the drug's role in the nephrotoxicity. After permanently stopping alectinib and switching to brigatinib, the patient achieved stable renal function and continued oncological response.
What made this case unusual
The case illustrates severe, reversible nephrotoxicity from alectinib, which is uncommon and particularly concerning in elderly patients with multiple health issues.
Diagnostic / clinical pearl
Clinicians should be vigilant for renal toxicity in elderly patients receiving alectinib, as it can lead to significant complications requiring dialysis.
Why it matters
This case underscores the importance of monitoring renal function in patients on alectinib and the potential for effective treatment with alternative ALK inhibitors.