{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:32:56Z","timestamp":1787668376719,"version":"build-2736575974"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T00:00:00Z","timestamp":1664409600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T00:00:00Z","timestamp":1664409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Targeted therapy with anaplastic lymphoma kinase inhibitor alectinib has become standard therapy for selected patients with non-small cell lung carcinoma. Few data are available on the renal effects of alectinib. We report on a case of acute kidney injury in a patient using alectinib for less than 2\u00a0weeks and on serum sodium and creatinine during long-term use of alectinib.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 70-year-old Asian woman was diagnosed with metastasized non-small cell lung carcinoma (cT4N3M1c, stage IV) with echinoderm microtubule-associated protein-like 4 and anaplastic lymphoma kinase gene rearrangement and received alectinib, in two daily doses of 600\u00a0mg. Eleven days after the initiation of therapy, she was seen at the emergency department with acute kidney injury. Renal biopsy showed lesions in the proximal tubular epithelial cells. Nine days after alectinib cessation, renal function recovered quickly and reintroduction of alectinib in a reduced dose was tolerated, while withholding metformin, enalapril, and naproxen. In seven other patients, data on estimated glomerular filtration rate showed decreased kidney function at 3\u00a0months with stabilization at 6\u00a0months. Serum sodium at 3\u00a0months increased during alectinib treatment and increased further at 6\u00a0months.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our data suggest direct or indirect toxic (proximal) tubulopathy due to alectinib with a good prognosis after cessation. Adverse acute renal effects of alectinib may be prevented by avoiding other medication influencing renal hemodynamics, in particular nonsteroidal anti-inflammatory drugs. Without these co-medications, alectinib could be reintroduced in our patient.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-022-03532-2","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T18:04:01Z","timestamp":1664474641000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Acute kidney injury and long-term renal effects of alectinib in anaplastic lymphoma kinase-positive non-small cell lung carcinoma: a case report"],"prefix":"10.1186","volume":"16","author":[{"given":"Marco","family":"van Londen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Roosma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Vogels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W. G.","family":"van Putten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilbert M. T.","family":"Janssen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,9,29]]},"reference":[{"key":"3532_CR1","doi-asserted-by":"publisher","first-page":"557","DOI":"10.3389\/fonc.2018.00557","volume":"8","author":"M Khan","year":"2018","unstructured":"Khan M, Lin J, Liao G, Tian Y, Liang Y, Li R, et\u00a0al. ALK inhibitors in the treatment of ALK positive NSCLC. Front Oncol. 2018;8:557.","journal-title":"Front Oncol"},{"key":"3532_CR2","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1016\/j.lungcan.2018.06.017","volume":"122","author":"L Meijer-Schaap","year":"2018","unstructured":"Meijer-Schaap L, Van Putten JWG, Janssen WMT. Effects of crizotinib on creatinine clearance and renal hemodynamics. Lung Cancer. 2018;122:192\u20134.","journal-title":"Lung Cancer"},{"key":"3532_CR3","doi-asserted-by":"publisher","first-page":"664","DOI":"10.1002\/cncr.28478","volume":"120","author":"EM Brosnan","year":"2014","unstructured":"Brosnan EM, Weickhardt AJ, Lu X, Maxon DA, Bar\u00f3n AE, Chonchol M, et\u00a0al. Drug-induced reduction in estimated glomerular filtration rate in patients with ALK-positive non-small cell lung cancer treated with the ALK inhibitor crizotinib. Cancer. 2014;120:664\u201374.","journal-title":"Cancer"},{"key":"3532_CR4","doi-asserted-by":"publisher","DOI":"10.1159\/000521452","author":"Q Zeng","year":"2021","unstructured":"Zeng Q, Zhang X, He S, Zhou Z, Xia L, Zhang W, et\u00a0al. Crizotinib versus alectinib for the treatment of ALK-positive non-small cell lung cancer: a systematic review and meta-analysis. Chemotherapy. 2021. https:\/\/doi.org\/10.1159\/000521452.","journal-title":"Chemotherapy"},{"key":"3532_CR5","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1186\/s13256-018-1849-y","volume":"12","author":"P Ramachandran","year":"2018","unstructured":"Ramachandran P, Morcus R, Tahir M, Onukogu I, Spinowitz B, Wang JC. Alectinib (Alecensa)-induced reversible grade IV nephrotoxicity: a case report and review of the literature. J Med Case Rep. 2018;12:303.","journal-title":"J Med Case Rep"},{"key":"3532_CR6","doi-asserted-by":"publisher","DOI":"10.1093\/omcr\/omy009","author":"K Nagai","year":"2018","unstructured":"Nagai K, Ono H, Matsuura M, Hann M, Ueda S, Yoshimoto S, et\u00a0al. Progressive renal insufficiency related to ALK inhibitor, alectinib. Oxford Med Case Rep. 2018. https:\/\/doi.org\/10.1093\/omcr\/omy009.","journal-title":"Oxford Med Case Rep."},{"key":"3532_CR7","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1056\/NEJMoa1704795","volume":"377","author":"S Peters","year":"2017","unstructured":"Peters S, Camidge DR, Shaw AT, Gadgeel S, Ahn JS, Kim D-W, et\u00a0al. Alectinib versus crizotinib in untreated ALK-positive non\u2013small-cell lung cancer. N Engl J Med. 2017;377:829\u201338.","journal-title":"N Engl J Med."},{"key":"3532_CR8","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1097\/00004872-199404000-00014","volume":"12","author":"WM Janssen","year":"1994","unstructured":"Janssen WM, de Zeeuw D, van der Hem GK, de Jong PE. Renal tubular sensitivity to atrial natriuretic factor in essential hypertension. J Hypertens. 1994;12:439\u201347.","journal-title":"J Hypertens."},{"key":"3532_CR9","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1080\/00365599.1988.11690398","volume":"22","author":"PA Sj\u00f6str\u00f6m","year":"1988","unstructured":"Sj\u00f6str\u00f6m PA, Odlind BG, Wolgast M. Extensive tubular secretion and reabsorption of creatinine in humans. Scand J Urol Nephrol. 1988;22:129\u201331.","journal-title":"Scand J Urol Nephrol."}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-022-03532-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-022-03532-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-022-03532-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T18:07:39Z","timestamp":1664474859000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-022-03532-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,29]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["3532"],"URL":"https:\/\/doi.org\/10.1186\/s13256-022-03532-2","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,29]]},"assertion":[{"value":"14 March 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 June 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 September 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study has been approved by the local medical ethics committee (2021-073).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"347"}}