Case Report: Severe brigatinib-induced pneumonitis in a patient with EML4–ALK+ metastatic non-small cell lung adenocarcinoma

Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs), such as brigatinib, are targeted therapies for metastatic non-small cell lung cancer (mNSCLC). We present a patient with echinoderm microtubule-associated protein-like 4 (EML4) and ALK fusion protein-positive mNSCLC who developed se...

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Bibliographic Details
Main Authors: Khyati Somayaji Dasika, Megan Melody, Jyoti D. Patel
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1572425/full
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Summary:Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs), such as brigatinib, are targeted therapies for metastatic non-small cell lung cancer (mNSCLC). We present a patient with echinoderm microtubule-associated protein-like 4 (EML4) and ALK fusion protein-positive mNSCLC who developed severe hypoxemia and pneumonitis requiring intubation within 2 days of initiating brigatinib therapy. The workup for alternative etiologies of respiratory distress was unrevealing, and the patient was treated for presumed brigatinib-induced pneumonitis with high-dose methylprednisolone. This case demonstrates high-grade, rapidly progressive brigatinib-induced pneumonitis with prompt clinical improvement after steroids and a marked disease response without recurring toxicity after treatment with an alternative ALK TKI, alectinib.
ISSN:2234-943X