The final, formatted version of the article will be published soon.
CASE REPORT article
Front. Oncol.
Sec. Thoracic Oncology
Volume 14 - 2024 |
doi: 10.3389/fonc.2024.1398414
This article is part of the Research Topic Treatment Response and Resistance to Targeted Therapies for NSCLC View all 13 articles
Appendicitis while on Alectinib for Non-Small Cell Lung Cancer: A Tale of Two Case Reports
Provisionally accepted- 1 The Ottawa Hospital, Ottawa, Ontario, Canada
- 2 University of Ottawa, Ottawa, Ontario, Canada
- 3 Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
Introduction: Aberrant expression of anaplastic lymphoma kinase (ALK) is found in 3-7% of patients with non-small cell lung cancer (NSCLC). Alectinib is a tyrosine kinase inhibitor used as first-line treatment targeting ALK-positive tumors. We herein report two cases of appendicitis highlighting it as a rare, possible adverse event of treatment with alectinib.Case presentation: The first case is a 60-year-old woman with a previous history of stage 1 lobular breast cancer and early-stage lung cancer treated with segmentectomy, subsequently presenting with ALK-positive advanced NSCLC. Treatment with alectinib resulted in partial response, but she developed gastrointestinal symptoms that were assessed with computed tomography (CT) of abdomen revealing right lower quadrant stranding without appendiceal visualization. Her symptoms continued despite antibiotic course with re-imaging concerning for acute appendicitis, which was successfully treated with appendectomy and amoxicillin-clavulanic acid. The second case is a previously healthy 58-year-old man with advanced ALK positive NSCLC who was started on first line treatment with alectinib and subsequently diagnosed with asymptomatic acute appendicitis on re-staging CT abdomen. Signs on CT resolved with amoxicillin-clavulanic acid.Definitive treatment was conducted with a delayed elective appendectomy. Both patients remained on alectinib over the courses of appendicitis without interruption. Conclusion: While appendicitis has not been previously described as an adverse effect of alectinib, its incidence in two patients at our center within several months following administration of alectinib raises its suspicion as a possible adverse effect.
Keywords: Alectinib, Appendicitis, NSCLC, case report, Cancer
Received: 09 Mar 2024; Accepted: 02 Sep 2024.
Copyright: © 2024 Wheatley-Price, Wong, Shah, Sekhon and Moore. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Sara Moore, The Ottawa Hospital, Ottawa, K1Y 4E9, Ontario, Canada
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.