Case report: Alectinib-associated intestinal ulceration and colitis in a patient with non-small cell lung cancer and effective treatment with Mesalazine
BackgroundAlectinib is effective in extending the survival of patients with anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) and generally has manageable side effects. However, intestinal ulcers and colitis are rare but serious adverse reactions linked to Alectinib, merit...
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Frontiers Media S.A.
2025-03-01
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| Series: | Pathology and Oncology Research |
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| Online Access: | https://www.por-journal.com/articles/10.3389/pore.2025.1612040/full |
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| author | Zijian Qiu Fei Ke Xiaoping Zhu |
| author_facet | Zijian Qiu Fei Ke Xiaoping Zhu |
| author_sort | Zijian Qiu |
| collection | DOAJ |
| description | BackgroundAlectinib is effective in extending the survival of patients with anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) and generally has manageable side effects. However, intestinal ulcers and colitis are rare but serious adverse reactions linked to Alectinib, meriting further investigation into their causes.Case presentationWe report the case of a 62-year-old woman with NSCLC and brain metastases, who tested positive for ALK. She had been treated with Alectinib for nearly 4 years. The patient experienced diarrhea for 4 days, and a subsequent colonoscopy revealed pancolitis along with multiple ulcers in the terminal ileum and ileocecal valve. Given the severity of these symptoms, classified as a grade 3 adverse event by the Common Terminology Criteria for Adverse Events (CTCAE), Alectinib was discontinued. Treatment with oral enteric-coated Mesalazine tablets led to a resolution of the diarrhea and a significant improvement in the pancolitis and ulcers upon follow-up. The patient’s anticancer therapy was subsequently switched to Ceritinib capsules. At follow-up, she demonstrated a stable tumor condition with no recurrence of intestinal ulcers or colitis.ConclusionTo our knowledge, this is the first reported case of intestinal ulceration and colitis induced by Alectinib. Although such adverse events are exceedingly rare, they require vigilant monitoring in clinical practice. Decisions on continuing with Alectinib should consider the severity of side effects, classified by CTCAE grade. For managing these specific adverse events, oral Mesalazine enteric-coated tablets appear to be an effective treatment option. |
| format | Article |
| id | doaj-art-1671c6ec14814ff08076371384d02be6 |
| institution | DOAJ |
| issn | 1532-2807 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Pathology and Oncology Research |
| spelling | doaj-art-1671c6ec14814ff08076371384d02be62025-08-20T03:01:22ZengFrontiers Media S.A.Pathology and Oncology Research1532-28072025-03-013110.3389/pore.2025.16120401612040Case report: Alectinib-associated intestinal ulceration and colitis in a patient with non-small cell lung cancer and effective treatment with MesalazineZijian Qiu0Fei Ke1Xiaoping Zhu2Department of Radiation Oncology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, ChinaDepartment of Pathology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, ChinaDepartment of Radiation Oncology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, ChinaBackgroundAlectinib is effective in extending the survival of patients with anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) and generally has manageable side effects. However, intestinal ulcers and colitis are rare but serious adverse reactions linked to Alectinib, meriting further investigation into their causes.Case presentationWe report the case of a 62-year-old woman with NSCLC and brain metastases, who tested positive for ALK. She had been treated with Alectinib for nearly 4 years. The patient experienced diarrhea for 4 days, and a subsequent colonoscopy revealed pancolitis along with multiple ulcers in the terminal ileum and ileocecal valve. Given the severity of these symptoms, classified as a grade 3 adverse event by the Common Terminology Criteria for Adverse Events (CTCAE), Alectinib was discontinued. Treatment with oral enteric-coated Mesalazine tablets led to a resolution of the diarrhea and a significant improvement in the pancolitis and ulcers upon follow-up. The patient’s anticancer therapy was subsequently switched to Ceritinib capsules. At follow-up, she demonstrated a stable tumor condition with no recurrence of intestinal ulcers or colitis.ConclusionTo our knowledge, this is the first reported case of intestinal ulceration and colitis induced by Alectinib. Although such adverse events are exceedingly rare, they require vigilant monitoring in clinical practice. Decisions on continuing with Alectinib should consider the severity of side effects, classified by CTCAE grade. For managing these specific adverse events, oral Mesalazine enteric-coated tablets appear to be an effective treatment option.https://www.por-journal.com/articles/10.3389/pore.2025.1612040/fullAlectinibintestinal ulcercolitisanaplastic lymphoma kinase inhibitornon-small cell lung cancer |
| spellingShingle | Zijian Qiu Fei Ke Xiaoping Zhu Case report: Alectinib-associated intestinal ulceration and colitis in a patient with non-small cell lung cancer and effective treatment with Mesalazine Pathology and Oncology Research Alectinib intestinal ulcer colitis anaplastic lymphoma kinase inhibitor non-small cell lung cancer |
| title | Case report: Alectinib-associated intestinal ulceration and colitis in a patient with non-small cell lung cancer and effective treatment with Mesalazine |
| title_full | Case report: Alectinib-associated intestinal ulceration and colitis in a patient with non-small cell lung cancer and effective treatment with Mesalazine |
| title_fullStr | Case report: Alectinib-associated intestinal ulceration and colitis in a patient with non-small cell lung cancer and effective treatment with Mesalazine |
| title_full_unstemmed | Case report: Alectinib-associated intestinal ulceration and colitis in a patient with non-small cell lung cancer and effective treatment with Mesalazine |
| title_short | Case report: Alectinib-associated intestinal ulceration and colitis in a patient with non-small cell lung cancer and effective treatment with Mesalazine |
| title_sort | case report alectinib associated intestinal ulceration and colitis in a patient with non small cell lung cancer and effective treatment with mesalazine |
| topic | Alectinib intestinal ulcer colitis anaplastic lymphoma kinase inhibitor non-small cell lung cancer |
| url | https://www.por-journal.com/articles/10.3389/pore.2025.1612040/full |
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