Abstract
Background. Crizotinib is useful for the treatment of lung cancer in patients who are positive for the echinoderm microtubule-associated protein-like 4 (EML4)-anaplastic lymphoma kinase (ALK) fusion gene. However, when used therapeutically, this drug can have adverse effects on the gastrointestinal tract. Case. The patient was a 46-year-old female who was found to have a mass in the intermediate bronchus that formed a single bloc with the mediastinal lymph nodes (#7, #8) and atelectasis of the right middle and lower lobes on thoracic computed tomography (CT). She was subsequently diagnosed with cT4N3M1b stage IV lung adenocarcinoma. A partial response (PR) was achieved after four courses of chemotherapy and radiotherapy. The cancer subsequently recurred in the form of cervical and abdominal lymph node, lung, liver and bone metastases. Histopathology subsequently showed that the patient was positive for the ALK fusion gene. Odynophagia and retrosternal pain appeared on day 10 after the start of crizotinib therapy, and upper gastrointestinal endoscopy performed on day 15 of treatment revealed esophagitis. A temporary drug holiday from crizotinib was thus implemented. Treatment with crizotinib was resumed on day 36 of therapy after the esophagitis improved; however, it was subsequently discontinued when the esophagitis reappeared on day 49. The esophagitis eventually improved by day 57 of treatment. Conclusions. We herein described the case of a patient with lung adenocarcinoma who developed crizotinib-induced esophagitis.
