Crizotinib-induced Rectal Perforation with Abscess

Yanagisawa, Akiko; Hayama, Naoki; Amano, Hiroyuki; Nakamura, Makoto; Hirano, Satoshi; Nakamura, Sukeyuki; Tabeta, Hiroshi

doi:10.2169/internalmedicine.8214-16

Cited by 5 publications

(5 citation statements)

References 11 publications

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“…In particular, alectinib is an anaplastic lymphoma kinase (ALK) inhibitor used in patients with nonsmallcell lung cancer, harbouring ALK rearrangements. Even if ALK inhibitors have been associated with various adverse effects, such as visual disturbances, nausea and vomiting (8), to the best of our knowledge our patient represents the second case of PI associated to alectinib administration described in literature (9).…”

Section: S Brocchi Et Almentioning

confidence: 83%

Pneumatosis intestinalis and spontaneous perforation associated with drug toxicity in oncologic patients : a case series

Brocchi¹,

Parmeggiani²,

Gaudiano³

et al. 2021

AGEB

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Pneumatosis Intestinalis (PI) is a rare radiological finding defined as the presence of extra-luminal gas within the intestinal wall. Several anti-tumor drugs can induce a damage of the gastrointestinal walls as an adverse effect, causing loss of mucosal integrity and endoluminal gas diffusion, responsible for PI development. We retrospectively analyzed 8 cases of PI detected through radiological imaging in oncologic patients undergoing various therapeutic regimens: five patients were receiving chemotherapy, two molecular targeted therapy (MTT) and one immunotherapy. Three patients were asymptomatic and pneumatosis was incidentally detected at routinary follow-up CT and then treated conservatively. Five patients presented acute abdomen symptoms and in these cases bowel perforation was the cause of death. Our experience confirms PI and perforation as rare complications of drug toxicity, especially in oncologic patients treated with combinations of different anticancer drugs and documented the second reported case of PI associated with atezolizumab and alectinib single administration.

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Section: S Brocchi Et Almentioning

confidence: 83%

Pneumatosis intestinalis and spontaneous perforation associated with drug toxicity in oncologic patients : a case series

Brocchi¹,

Parmeggiani²,

Gaudiano³

et al. 2021

AGEB

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“…Our analysis found a significant signal for rectal perforation with crizotinib, but not with the other ALK inhibitors. Yanagisawa et al 13 reported a case of a 86-year-old male with stage IV lung adenocarcinoma who developed rectal perforation associated with crizotinib.…”

Section: Discussionmentioning

confidence: 99%

“…Yanagisawa et al. 13 reported a case of a 86-year-old male with stage IV lung adenocarcinoma who developed rectal perforation associated with crizotinib.…”

Section: Discussionmentioning

confidence: 99%

“…11 Treatment with ALK inhibitors is usually well tolerated; however, there are common class adverse events such as nausea, vomiting, diarrhea, pneumonitis, and cardiac toxicity. 12 Some less common adverse events have been reported as well including rectal perforation, 13 cataract, macular edema or blindness, 14,15 osteitis, 16 ventricular fibrillation, 17,18 pulmonary arterial hypertension, 19 pancreatitis, 20 cholestasis, 21 alopecia, 22 proteinuria, 23 myasthenia gravis, 24 toxic epidermal necrolysis, 25 sarcoid-like reaction, 26 and photosensitivity. 27 Treatment discontinuation due to adverse events among different ALK inhibitors were as follow: 12% with crizotinib as in the PROFILE 1014 trial, 28 5% with ceritinib as in the ASCEND 4 trial, 29 11% with alectinib as in the ALEX trial, 30 12% with brigatinib as in the ALTA-1L trial, 10 and 7% with lorlatinib as in the CROWN trial.…”

Section: Introductionmentioning

confidence: 99%

“…Treatment with ALK inhibitors is usually well tolerated; however, there are common class adverse events such as nausea, vomiting, diarrhea, pneumonitis, and cardiac toxicity. 12 Some less common adverse events have been reported as well including rectal perforation, 13 cataract, macular edema or blindness, 14 , 15 osteitis, 16 ventricular fibrillation, 17 , 18 pulmonary arterial hypertension, 19 pancreatitis, 20 cholestasis, 21 alopecia, 22 proteinuria, 23 myasthenia gravis, 24 toxic epidermal necrolysis, 25 sarcoid-like reaction, 26 and photosensitivity. 27 …”

Section: Introductionmentioning

confidence: 99%

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Postmarketing safety of anaplastic lymphoma kinase (ALK) inhibitors: an analysis of the FDA Adverse Event Reporting System (FAERS)

Omar¹,

Soliman²,

Eshra³

et al. 2021

ESMO Open

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Background: Inhibitors of the anaplastic lymphoma kinase (ALK) gene mutation are highly effective treatments for ALKpositive lung cancer. We conducted this pharmacovigilance analysis using the Food and Drug Administration Adverse Event Reporting System (FAERS). Patients and methods: FAERS files from 2012 to 2020 were used. Reports for crizotinib, ceritinib, alectinib, brigatinib, and lorlatinib were filtered. We used the Medical Dictionary for Regulatory Activities (MedDRA version 22.1). Further, we searched for adverse events on the preferred term (PT) level based on case reports in the literature. After filtering duplicate reports, disproportionality analysis was used to detect safety signals by calculating proportional reporting ratios (PRRs), reporting odds ratios (RORs), empirical Bayesian geometric mean, and information component. Reports were considered statistically significant if the 95% confidence interval did not contain the null value. Results: Within the system organ classes, significant safety signals were found, including those for crizotinib [eye disorders (PRR 2.09, ROR 2.12)], ceritinib [gastrointestinal disorders (PRR 2.19, ROR 2.41), hepatobiliary disorders (PRR 4.4, ROR 4.52), respiratory disorders (PRR 1.96, ROR 2.08)], alectinib [hepatobiliary disorders (PRR 2.60, ROR 2.63)], brigatinib [respiratory disorders (PRR 2.15, ROR 2.31)], and lorlatinib [metabolism disorders (PRR 3.34, ROR 3.53)]. For adverse events on the PT level, we found several significant signals, including pneumothorax with crizotinib (

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Anaplastic lymphoma kinase tyrosine kinase inhibitors associated gastrointestinal obstruction, perforation, and ulceration: an analysis of the FDA adverse event reporting system database (FAERS)

et al. 2022

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Crizotinib-induced Rectal Perforation with Abscess

Cited by 5 publications

References 11 publications

Pneumatosis intestinalis and spontaneous perforation associated with drug toxicity in oncologic patients : a case series

Pneumatosis intestinalis and spontaneous perforation associated with drug toxicity in oncologic patients : a case series

Postmarketing safety of anaplastic lymphoma kinase (ALK) inhibitors: an analysis of the FDA Adverse Event Reporting System (FAERS)

Anaplastic lymphoma kinase tyrosine kinase inhibitors associated gastrointestinal obstruction, perforation, and ulceration: an analysis of the FDA adverse event reporting system database (FAERS)

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