Crizotinib: Renal Safety Evaluation

2017 ◽  
Vol 1 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Mark A. Perazella ◽  
Hassan Izzedine
Keyword(s):  
Receptor Tyrosine Kinase ◽  
Safety Evaluation ◽  
Kidney Injury ◽  
Renal Cysts ◽  
Electrolyte Disorders ◽  
Insulin Receptor Tyrosine Kinase ◽  
Anaplastic Lymphoma ◽  
Molecule Inhibitor ◽  
Alk Positive ◽  
Receptor Tyrosine Kinase Family

Anaplastic lymphoma kinase 1 (ALK 1) is a member of the insulin receptor tyrosine kinase family. Crizotinib is a small molecule inhibitor available for clinical use, which is found within the ALK family of drugs. Several other ALK 1 inhibitors are currently being evaluated in preclinical and clinical trials. Crizotinib is approved for the treatment of advanced ALK positive non-small cell lung cancer (NSCLC). However, this drug is associated with various renal adverse effects. Treatment with crizotinib appears to be associated with pseudo- and true acute kidney injury. Peripheral edema and rare electrolyte disorders are also described with this ALK inhibitor. Finally, crizotinib also appears to increase the risk for the development and progression of renal cysts. This review focuses on the mechanism of action, clinical indications, pharmacology, and adverse renal effects of crizotinib.

scholarly journals Renal complication of crizotinib: Crizotinib-associated complex renal cyst

2020 ◽  
Vol 21 (1) ◽  
pp. 44-56
Author(s):  
Warissara Jutidamrongphan ◽  
Pimporn Puttawibul
Keyword(s):  
Renal Impairment ◽  
Kinase Inhibitors ◽  
Renal Cyst ◽  
Renal Cysts ◽  
Small Cell ◽  
Small Cell Lung ◽  
Anaplastic Lymphoma ◽  
Renal Complication ◽  
Alk Positive ◽  
Cyst Development

Crizotinib is one of the first generations of tyrosine kinase inhibitors targeting anaplastic lymphoma kinase(ALK) and is recently found to be associated with the development of complex renal cysts with inconclusive explanation up to this time. Hereby, we discuss the hypothesis of Crizotinib-associated complex renal cyst development and coexisting renal impairment after initiation of the treatment in a 75-year-old man with ALK-positive non-small cell lung cancer whose complex renal cysts evolved after initiation and cessation of Crizotinib treatment. The coexistence as renal impairment persisted even after switching from Crizotinib to Ceritinib.

scholarly journals Crizotinib-Associated Renal Cysts: A Case Series

2019 ◽  
Vol 02 (02) ◽  
pp. 130-134
Author(s):  
Garima Suman ◽  
Anurima Patra ◽  
Amit Janu ◽  
Akshay Baheti
Keyword(s):  
Case Series ◽  
Renal Cysts ◽  
Cell Lung Carcinoma ◽  
Anaplastic Lymphoma ◽  
Clinical Literature ◽  
Erroneous Diagnosis ◽  
Kidney Lesion ◽  
Alk Positive ◽  
Require Dose ◽  
Require Dose Reduction

AbstractCrizotinib is an anaplastic lymphoma kinase (ALK) inhibitor, used as a targeted chemotherapeutic agent in ALK-positive cases of nonsmall cell lung carcinoma. Although uncommon, it may be associated with the formation of new renal cysts, which may be simple or complex, or the enlargement of preexisting simple renal cysts or their transformation into complex cysts. These cysts usually regress partially or completely but may rarely enlarge over time or get complicated by infection or abscess formation. Such cases may even require dose reduction or withholding crizotinib. Although documented in clinical literature, this entity is not well known among radiologists. Knowledge of this entity helps in preventing erroneous diagnosis of the new kidney “lesion” as metastasis or disease progression and avoids an unnecessary biopsy. We describe a series of four cases which developed complex renal cysts during treatment with crizotinib to demonstrate this point.

scholarly journals Renal complication of crizotinib: Crizotinib-associated complex renal cyst

2020 ◽  
pp. 44-56 ◽  
Author(s):  
Warissara Jutidamrongphan ◽  
Pimporn Puttawibul
Keyword(s):  
Renal Impairment ◽  
Kinase Inhibitors ◽  
Renal Cyst ◽  
Renal Cysts ◽  
Small Cell ◽  
Small Cell Lung ◽  
Anaplastic Lymphoma ◽  
Renal Complication ◽  
Alk Positive ◽  
Cyst Development

Crizotinib is one of the first generations of tyrosine kinase inhibitors targeting anaplastic lymphoma kinase(ALK) and is recently found to be associated with the development of complex renal cysts with inconclusive explanation up to this time. Hereby, we discuss the hypothesis of Crizotinib-associated complex renal cyst development and coexisting renal impairment after initiation of the treatment in a 75-year-old man with ALK-positive non-small cell lung cancer whose complex renal cysts evolved after initiation and cessation of Crizotinib treatment. The coexistence as renal impairment persisted even after switching from Crizotinib to Ceritinib.

scholarly journals Renal Complications Related to Checkpoint Inhibitors: Diagnostic and Therapeutic Strategies

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1187
Author(s):  
Julie Belliere ◽  
Julien Mazieres ◽  
Nicolas Meyer ◽  
Leila Chebane ◽  
Fabien Despas
Keyword(s):  
Checkpoint Inhibitors ◽  
Treatment Strategies ◽  
Kidney Injury ◽  
Immunosuppressive Drugs ◽  
Peripheral Tolerance ◽  
Electrolyte Disorders ◽  
Glomerular Diseases ◽  
Renal Complications ◽  
Lower Baseline ◽  
Low Incidence

Immune checkpoint inhibitors (ICI) targeting CTLA-4 and the PD-1/PD-L1 axis have unprecedentedly improved global prognosis in several types of cancers. However, they are associated with the occurrence of immune-related adverse events. Despite their low incidence, renal complications can interfere with the oncologic strategy. The breaking of peripheral tolerance and the emergence of auto- or drug-reactive T-cells are the main pathophysiological hypotheses to explain renal complications after ICI exposure. ICIs can induce a large spectrum of renal symptoms with variable severity (from isolated electrolyte disorders to dialysis-dependent acute kidney injury (AKI)) and presentation (acute tubule-interstitial nephritis in >90% of cases and a minority of glomerular diseases). In this review, the current trends in diagnosis and treatment strategies are summarized. The diagnosis of ICI-related renal complications requires special steps to avoid confounding factors, identify known risk factors (lower baseline estimated glomerular filtration rate, proton pump inhibitor use, and combination ICI therapy), and prove ICI causality, even after long-term exposure (weeks to months). A kidney biopsy should be performed as soon as possible. The treatment strategies rely on ICI discontinuation as well as co-medications, corticosteroids for 2 months, and tailored immunosuppressive drugs when renal response is not achieved.

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