Organizing pneumonia in ALK+ non-small cell lung cancer treated with ceritinib: a case report

Abstract Introduction Anaplastic lymphoma kinase (ALK) inhibitors have been approved for non-small cell lung cancer (NSCLC) patients with ALK-rearrangement. Ceritinib, a clinically approved ALK inhibitor, is associated with some adverse reactions, including organizing pneumonia (OP). However, few ca...

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Main Authors: Xiao Lin, Mengyao Xie, Dandan Ma, Dandan Zheng, Jingjing Liu, Jinyan Ye, Lehe Yang, Yao Lu
Format: Article
Language:English
Published: Springer 2025-07-01
Series:Discover Oncology
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Online Access:https://doi.org/10.1007/s12672-025-02904-6
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author Xiao Lin
Mengyao Xie
Dandan Ma
Dandan Zheng
Jingjing Liu
Jinyan Ye
Lehe Yang
Yao Lu
author_facet Xiao Lin
Mengyao Xie
Dandan Ma
Dandan Zheng
Jingjing Liu
Jinyan Ye
Lehe Yang
Yao Lu
author_sort Xiao Lin
collection DOAJ
description Abstract Introduction Anaplastic lymphoma kinase (ALK) inhibitors have been approved for non-small cell lung cancer (NSCLC) patients with ALK-rearrangement. Ceritinib, a clinically approved ALK inhibitor, is associated with some adverse reactions, including organizing pneumonia (OP). However, few cases of ceritinib-induced OP have been reported to date. Patient concerns A 59-year-old female patient with ALK + lung adenocarcinoma presented with paroxysmal cough lasting 3 months. Antibiotic therapy was not effective, and blood and sputum cultures were negative. Diagnosis A computed tomography (CT)-guided biopsy of the left upper lung was performed and hematoxylin–eosin staining was consistent with OP. The diagnosis of ceritinib-induced OP was considered based on these results. Interventions Ceritinib was then stopped, and the patient was treated with methylprednisolone (40 mg ivgtt qd) for one week. The dose was lowered to 32 mg po qd with regular follow-up. Later, the patient switched to another ALK inhibitor, ensartinib, for treatment, and the steroid was discontinued after two months. Outcomes A Chest CT scan after one week of treatment showed progressive disappearance of lung lesions, and the patient was discharged on oral methylprednisolone (32 mg qd) for two weeks after which the dose was reduced gradually. Conclusion OP should be considered when new lesions appear in the lungs of lung cancer patients, and distinguished from infectious pneumonia, metastasis, or cancer progression. In this respect, pathological biopsy plays an important role in diagnosis. In our case, discontinuation of ceritinib and regular steroid administration were effective.
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spelling doaj-art-d1fde1f7749643cca84281ad8ba4ecca2025-08-20T03:43:03ZengSpringerDiscover Oncology2730-60112025-07-011611810.1007/s12672-025-02904-6Organizing pneumonia in ALK+ non-small cell lung cancer treated with ceritinib: a case reportXiao Lin0Mengyao Xie1Dandan Ma2Dandan Zheng3Jingjing Liu4Jinyan Ye5Lehe Yang6Yao Lu7The First Affiliated Hospital, Wenzhou Medical UniversityAffiliated Shaoxing People’s Hospital, Zhejiang UniversityThe First Affiliated Hospital, Wenzhou Medical UniversityThe First Affiliated Hospital, Wenzhou Medical UniversityThe First Affiliated Hospital, Wenzhou Medical UniversityThe First Affiliated Hospital, Wenzhou Medical UniversityThe First Affiliated Hospital, Wenzhou Medical UniversityThe First Affiliated Hospital, Wenzhou Medical UniversityAbstract Introduction Anaplastic lymphoma kinase (ALK) inhibitors have been approved for non-small cell lung cancer (NSCLC) patients with ALK-rearrangement. Ceritinib, a clinically approved ALK inhibitor, is associated with some adverse reactions, including organizing pneumonia (OP). However, few cases of ceritinib-induced OP have been reported to date. Patient concerns A 59-year-old female patient with ALK + lung adenocarcinoma presented with paroxysmal cough lasting 3 months. Antibiotic therapy was not effective, and blood and sputum cultures were negative. Diagnosis A computed tomography (CT)-guided biopsy of the left upper lung was performed and hematoxylin–eosin staining was consistent with OP. The diagnosis of ceritinib-induced OP was considered based on these results. Interventions Ceritinib was then stopped, and the patient was treated with methylprednisolone (40 mg ivgtt qd) for one week. The dose was lowered to 32 mg po qd with regular follow-up. Later, the patient switched to another ALK inhibitor, ensartinib, for treatment, and the steroid was discontinued after two months. Outcomes A Chest CT scan after one week of treatment showed progressive disappearance of lung lesions, and the patient was discharged on oral methylprednisolone (32 mg qd) for two weeks after which the dose was reduced gradually. Conclusion OP should be considered when new lesions appear in the lungs of lung cancer patients, and distinguished from infectious pneumonia, metastasis, or cancer progression. In this respect, pathological biopsy plays an important role in diagnosis. In our case, discontinuation of ceritinib and regular steroid administration were effective.https://doi.org/10.1007/s12672-025-02904-6CeritinibALK + Non-small cell lung cancerOrganizing pneumoniaCase report
spellingShingle Xiao Lin
Mengyao Xie
Dandan Ma
Dandan Zheng
Jingjing Liu
Jinyan Ye
Lehe Yang
Yao Lu
Organizing pneumonia in ALK+ non-small cell lung cancer treated with ceritinib: a case report
Discover Oncology
Ceritinib
ALK + 
Non-small cell lung cancer
Organizing pneumonia
Case report
title Organizing pneumonia in ALK+ non-small cell lung cancer treated with ceritinib: a case report
title_full Organizing pneumonia in ALK+ non-small cell lung cancer treated with ceritinib: a case report
title_fullStr Organizing pneumonia in ALK+ non-small cell lung cancer treated with ceritinib: a case report
title_full_unstemmed Organizing pneumonia in ALK+ non-small cell lung cancer treated with ceritinib: a case report
title_short Organizing pneumonia in ALK+ non-small cell lung cancer treated with ceritinib: a case report
title_sort organizing pneumonia in alk non small cell lung cancer treated with ceritinib a case report
topic Ceritinib
ALK + 
Non-small cell lung cancer
Organizing pneumonia
Case report
url https://doi.org/10.1007/s12672-025-02904-6
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