Hypersensitivity in ALK-positive lung cancers exposed to ALK inhibitors: a case of successful switch to an alternative ALK inhibitor and systematic review of the literature

Abstract

Lei Deng,1 Janaki Sharma,2 Elizabeth Ravera,2 Balazs Halmos,2 Haiying Cheng2 1Department of Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA; 2Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA Abstract: Alectinib can cause rare, but severe hypersensitivity. The cross-reactivity between different ALK inhibitors is unknown and desensitization is the only reported management. We hereby report the first case of severe delayed hypersensitivity developed in a lung cancer patient treated by alectinib, who was successfully managed by switching to brigatinib, another ALK inhibitor. The patient achieved excellent anti-tumor response to brigatinib. Our case provides an alternative and safe strategy in patients with alectinib-related hypersensitivity. Keywords: alectinib, brigatinib

Keywords

• Hypersensitivity
• ALK
• alectinib
• brigatinib
• lung cancer