Perforation of the descending colon induced by alectinib in a patient with non-small cell lung cancer: a Case Report.

in Frontiers in pharmacology by Yun Li, Ping Yu, Ran Wang

TLDR

  • Alectinib, a lung cancer treatment, can cause a hole in the colon (perforation) as a serious side effect.
  • Clinicians should be aware of this risk and manage symptoms promptly.
  • Further research is needed to understand the mechanisms and prevent this complication.

Abstract

Anaplastic lymphoma kinase (ALK) inhibitor alectinib has demonstrated significant potential in treating non-small cell lung cancer (NSCLC); however, its adverse effects remain a notable challenge for healthcare professionals. This report examines the case of a 79-year-old female lung cancer patient who presented with persistent colic in the left abdomen 10 months after initiating alectinib treatment. Upon admission, abdominal computed tomography revealed mild thickening of the descending colon wall, accompanied by free gas and surrounding exudation, leading to a diagnosis of descending colon perforation. After excluding alternative causes of gastrointestinal perforation, the condition was attributed to a severe adverse reaction associated with alectinib. While alectinib has been reported to cause serious gastrointestinal perforations, the underlying mechanism remains unclear and warrants further clinical investigation. Clinicians should be vigilant in recognizing and promptly managing this potential complication during alectinib therapy.

Overview

  • This study examines a case of a 79-year-old female lung cancer patient who developed descending colon perforation after 10 months of alectinib treatment.
  • The patient presented with persistent colic in the left abdomen and underwent abdominal computed tomography, revealing mild thickening of the descending colon wall and surrounding exudation.
  • The condition was attributed to a severe adverse reaction associated with alectinib, highlighting the need for clinicians to recognize and promptly manage this potential complication.

Comparative Analysis & Findings

  • Alectinib has been reported to cause serious gastrointestinal perforations, but the underlying mechanism remains unclear.
  • The case study presented highlights the potential risk of colon perforation as a serious adverse effect of alectinib treatment.
  • The diagnosis was made after excluding alternative causes of gastrointestinal perforation, and the patient ultimately required hospitalization for treatment.

Implications and Future Directions

  • Clinicians should be vigilant in recognizing and promptly managing potential complications of alectinib therapy.
  • Further clinical investigation is warranted to better understand the underlying mechanisms of alectinib-induced gastrointestinal perforations.
  • This knowledge can inform the development of strategies to prevent or mitigate this adverse effect.
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