{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:08:47Z","timestamp":1787843327069,"version":"build-2784847793"},"reference-count":22,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2020,2,13]],"date-time":"2020-02-13T00:00:00Z","timestamp":1581552000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Actionable mutations are tested as standard of care for all new metastatic non-small cell lung cancers. Tumors harboring an anaplastic lymphoma kinase mutation respond to tyrosine kinase inhibitors targeting anaplastic lymphoma kinase pathway. Patients are monitored for common adverse effects, although we occasionally encounter unexpected side effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report<\/jats:title>\n                    <jats:p>A 52-year-old male presented with a right hilar lung mass, and workup revealed a stage IIIA adenocarcinoma. He underwent treatment with concurrent chemoradiation; however, disease recurred one year later with a right hilar mass and contralateral mediastinal lymphadenopathy, biopsy of which resulted positive for adenocarcinoma. Molecular analysis showed anaplastic lymphoma kinase rearrangement and alectinib was started. Six\u2009months into therapy, he presented with hematochezia, nausea, and epigastric pain and was diagnosed with acute pancreatitis. Triglyceride level resulted above the measurable level at &gt;5680mg\/dL, thought to be the inciting event of pancreatitis. Management and outcome: Despite treatment with intravenous hydration, insulin infusion, and antibiotics, he decompensated with development of respiratory failure, shock requiring intensive care. Therapeutic plasmapheresis was initiated due to persistently elevated triglyceride. Following the third plasmapheresis, triglyceride level decreased to 359\u2009mg\/dL. With aggressive multidisciplinary management, he made a complete recovery. Follow-up imaging studies at three and six\u2009months show a stable mass-like abnormality in the right hilum without evidence of disease progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Prior to starting alectinib, our patient\u2019s triglyceride level was 420\u2009mg\/dL. While he consumed alcohol, he had no other traditional risk factor. To our knowledge, this is the first reported case of hypertriglyceridemia-induced acute pancreatitis related to treatment with an anaplastic lymphoma kinase inhibitor.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1078155220904141","type":"journal-article","created":{"date-parts":[[2020,2,14]],"date-time":"2020-02-14T00:28:36Z","timestamp":1581640116000},"page":"1533-1537","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Life-threatening hypertriglyceridemia-induced pancreatitis related to alectinib successfully treated by plasmapheresis: A review of the literature on metabolic toxicities associated with anaplastic lymphoma kinase inhibitors"],"prefix":"10.1177","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0122-7816","authenticated-orcid":false,"given":"Arundati","family":"Rao","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Connecticut Health, Farmington, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aswanth","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Connecticut Health, Farmington, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0440-1445","authenticated-orcid":false,"given":"Corey","family":"Dinunno","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Connecticut Health, Farmington, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Elali","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Connecticut Health, Farmington, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,2,13]]},"reference":[{"key":"bibr1-1078155220904141","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1703413"},{"key":"bibr2-1078155220904141","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2013.07.025"},{"key":"bibr3-1078155220904141","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704795"},{"key":"bibr4-1078155220904141","unstructured":"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2018\/208434s004lbl.pdf. Reference ID: 4273596  (accessed  June 2018)."},{"key":"bibr5-1078155220904141","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"},{"key":"bibr6-1078155220904141","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21705"},{"key":"bibr7-1078155220904141","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000001190"},{"key":"bibr8-1078155220904141","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2017.06.070"},{"key":"bibr9-1078155220904141","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30565-2"},{"key":"bibr10-1078155220904141","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)00488-X"},{"key":"bibr11-1078155220904141","unstructured":"Dental and Pharmaceutical Benefits Agency (TLV), Main Association of Austrian Social Security Institutions (HVB), Agency for Quality and Accreditation in Health Care and Social Welfare (AAZ). Rapid assessment on pharmaceutical technologies using the HTA Core Model for Rapid Relative Effectiveness Assessment. Alectinib as monotherapy for the first-line treatment of adult patients with ALK-positive advanced non-small cell lung cancer. 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