Successful treatment of an elderly lung cancer patient harboring EML4-ALK fusion gene by crizotinib
Kazuna Hayashia Tomoko Yamagishib,c Nobuaki Ochib Nobuhiro Hondab Hiromichi Yamaneb Nagio Takigawab
aClinical Education and Training Center, Kawasaki Hospital, Kawasaki Medical School
bDepartment of General Internal Medicine 4, Kawasaki Hospital, Kawasaki Medical School
cDepartment of Respiratory Medicine, Okayama Rosai Hospital
An 89-year-old man presented with increased left pleural effusion on chest X-ray. Seven months before, he had received combination chemotherapy for advanced lung adenocarcinoma (T3N3M1b, stage IV) in the left lower lobe. A cytological examination using pleural effusion revealed adenocarcinoma cells with EML4-ALK fusion genes. A positron emission tomography scan showed no accumulation of fluorodeoxyglucose five weeks after treatment with crizotinib. Six weeks later, the patient developed asymptomatic profound sinus bradycardia (heart rate, 45/min) and recovered by a dose reduction of crizotinib. Since elderly patients were reported to be quite likely to experience sinus bradycardia by crizotinib, we should exercise caution in regard to the adverse effect.
Pulmonary adenocarcinoma EML4-ALK fusion gene Crizotinib Elderly Bradycardia
Received 2 Feb 2015 / Accepted 19 Mar 2015
AJRS, 4(4): 278-282, 2015