PMID- 23617826
OWN - NLM
STAT- MEDLINE
DCOM- 20150127
LR  - 20211021
IS  - 1471-2407 (Electronic)
IS  - 1471-2407 (Linking)
VI  - 13
DP  - 2013 Apr 26
TI  - Early pneumothorax as a feature of response to crizotinib therapy in a patient 
      with ALK rearranged lung adenocarcinoma.
PG  - 207
LID - 10.1186/1471-2407-13-207 [doi]
AB  - BACKGROUND: Single arm phase 1 and 2 studies on Crizotinib in ALK-positive 
      patients so far have shown rapid and durable responses. Spontaneous 
      pneumothoraces as a result of response to anti-cancer therapy are rare in 
      oncology but have been documented in a number of tumour types including lung 
      cancer. This includes cytotoxic chemotherapy as well as molecular targeted agents 
      such as gefitinib and Bevacizumab. These often require chest drain insertion or 
      surgical intervention with associated morbidity and mortality. They have also 
      been associated with response to treatment. This is the first report we are aware 
      of documenting pneumothorax as response to crizotinib therapy. CASE PRESENTATION: 
      A 48-year-old Caucasian male presented with a Stage IV, TTF1 positive, EGFR 
      wild-type adenocarcinoma of the lung. He received first line chemotherapy with 
      three cycles of cisplatin-pemetrexed chemotherapy with a differential response, 
      and then second-line erlotinib for two months before further radiological 
      evidence of disease progression. Further analysis of his diagnostic specimen 
      identified an ALK rearrangement by fluorescence in situ hybridization (FISH). He 
      was commenced on crizotinib therapy 250 mg orally twice daily. At his 4-week 
      assessment he had a chest radiograph that identified a large left-sided 
      pneumothorax with disease response evident on the right. Chest CT confirmed a 50% 
      left-sided pneumothorax on a background of overall disease response. A chest tube 
      was inserted with complete resolution of the pneumothorax that did not recur 
      following its removal. CONCLUSION: Our case demonstrates this potential 
      complication of crizotinib therapy and we therefore recommend that pneumothorax 
      be considered in patients on crizotinib presenting with high lung metastatic 
      burden and with worsening dyspnoea.
FAU - Gennatas, Spyridon
AU  - Gennatas S
FAU - Stanway, Susana J
AU  - Stanway SJ
FAU - Thomas, Robert
AU  - Thomas R
FAU - Min, Toon
AU  - Min T
FAU - Shah, Riyaz
AU  - Shah R
FAU - O'Brien, Mary E R
AU  - O'Brien ME
FAU - Popat, Sanjay
AU  - Popat S
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130426
PL  - England
TA  - BMC Cancer
JT  - BMC cancer
JID - 100967800
RN  - 0 (Protein Kinase Inhibitors)
RN  - 0 (Pyrazoles)
RN  - 0 (Pyridines)
RN  - 53AH36668S (Crizotinib)
RN  - EC 2.7.10.1 (ALK protein, human)
RN  - EC 2.7.10.1 (Anaplastic Lymphoma Kinase)
RN  - EC 2.7.10.1 (Receptor Protein-Tyrosine Kinases)
SB  - IM
MH  - Adenocarcinoma/complications/*drug therapy/genetics/pathology
MH  - Anaplastic Lymphoma Kinase
MH  - Carcinoma, Non-Small-Cell Lung/complications/*drug therapy/genetics/pathology
MH  - Crizotinib
MH  - *Gene Rearrangement
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Lung Neoplasms/complications/*drug therapy/genetics/pathology
MH  - Male
MH  - Middle Aged
MH  - Pneumothorax/*chemically induced/diagnosis
MH  - Prognosis
MH  - Protein Kinase Inhibitors/*adverse effects
MH  - Pyrazoles/*adverse effects
MH  - Pyridines/*adverse effects
MH  - Receptor Protein-Tyrosine Kinases/*genetics
PMC - PMC3640977
EDAT- 2013/04/27 06:00
MHDA- 2015/01/28 06:00
PMCR- 2013/04/26
CRDT- 2013/04/27 06:00
PHST- 2012/09/19 00:00 [received]
PHST- 2013/04/16 00:00 [accepted]
PHST- 2013/04/27 06:00 [entrez]
PHST- 2013/04/27 06:00 [pubmed]
PHST- 2015/01/28 06:00 [medline]
PHST- 2013/04/26 00:00 [pmc-release]
AID - 1471-2407-13-207 [pii]
AID - 10.1186/1471-2407-13-207 [doi]
PST - epublish
SO  - BMC Cancer. 2013 Apr 26;13:207. doi: 10.1186/1471-2407-13-207.