Zhang Y, Xu YY, Chen Y, Li JN, Wang Y. Crizotinib-induced acute fatal liver failure in an Asian ALK-positive lung adenocarcinoma patient with liver metastasis: A case report. World J Clin Cases 2019; 7(9): 1080-1086 [PMID: 31123682 DOI: 10.12998/wjcc.v7.i9.1080]
Corresponding Author of This Article
Ying Wang, MSc, Professor, Department of Oncology, Shengjing Hospital of China Medical University, 39 Huaxiang Street, Tiexi District, Shenyang 110022, Liaoning Province, China. wang_ying@sj-hospital.org
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 6, 2019; 7(9): 1080-1086 Published online May 6, 2019. doi: 10.12998/wjcc.v7.i9.1080
Crizotinib-induced acute fatal liver failure in an Asian ALK-positive lung adenocarcinoma patient with liver metastasis: A case report
Ying Zhang, Yan-Yan Xu, Yi Chen, Jin-Na Li, Ying Wang
Ying Zhang, Yan-Yan Xu, Yi Chen, Jin-Na Li, Ying Wang, Department of Oncology, Shengjing Hospital of China Medical University, Shenyang 110022, Liaoning Province, China
Author contributions: Zhang Y collected the patient’s clinical data and drafted the manuscript; Xu YY reviewed the literature; Chen Y and Li JN contributed to analysis and interpretation of the imaging; Wang Y collected the patient’s clinical data and revised the manuscript; all authors issued final approval for the version to be submitted.
Informed consent statement: Consent was obtained from the patient’s relatives for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ying Wang, MSc, Professor, Department of Oncology, Shengjing Hospital of China Medical University, 39 Huaxiang Street, Tiexi District, Shenyang 110022, Liaoning Province, China. wang_ying@sj-hospital.org
Telephone: +86-24-9661563311
Received: December 25, 2018 Peer-review started: December 27, 2018 First decision: January 30, 2019 Revised: February 25, 2019 Accepted: March 8, 2019 Article in press: March 8, 2019 Published online: May 6, 2019 Processing time: 132 Days and 20.7 Hours
Abstract
BACKGROUND
Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old Asian patient.
CASE SUMMARY
The patient complained of dyspnea and upper abdominal pain for a week in August 2017. He was diagnosed with anaplastic lymphoma kinase-rearranged lung adenocarcinoma combined with multiple distant metastases. Crizotinib was initiated as a first-line treatment at a dosage of 250 mg twice daily. No adverse effects were seen until day 46. On day 55, he was admitted to the hospital with elevated liver enzymes aspartate aminotransferase (AST) (402 IU/L), alanine aminotransferase (ALT) (215 IU/L) and total bilirubin (145 μmol/L) and was diagnosed with crizotinib-induced fulminant liver failure. Despite crizotinib discontinuation and intensive supportive therapy, the level of AST (1075 IU/L), ALT (240 IU/L) and total bilirubin (233 μmol/L) continued to rapidly increase, and he died on day 60.
CONCLUSION
Physicians should be aware of the potential fatal adverse effects of crizotinib.
Core tip: Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop to fatal liver failure. We report a case of fatal crizotinib-induced liver failure in a 37-year-old Asian patient with anaplastic lymphoma kinase-rearranged lung adenocarcinoma combined with hepatic metastasis. Physicians should be aware of the potential fatal adverse effect of crizotinib. The King’s College Criteria and weekly monitoring of liver enzymes are necessary to diagnose and evaluate crizotinib-induced liver failure.
