Symptomatic Bradycardia Due to Alectinib in a Patient with Advanced Stage of NSCLC

Authors

  • Ceva Wicaksono Pitoyo Division of Respirology and Critical Care Internal Medicine, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
  • Cleopas Martin Rumende Division of Respirology and Critical Care Internal Medicine, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
  • Anindita Kartika Wiraputri Division of Respirology and Critical Care Internal Medicine, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
  • Fatira Ratri Audita Division of Respirology and Critical Care Internal Medicine, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Keywords:

alectinib, bradycardia, NSCLC

Abstract

Alectinib is one of the targeted therapies commonly given to patients with advanced non-small cell lung cancer (NSCLC) with mutations in the ALK gene. The most common adverse effects of alectinib are fatigue, constipation, edema, myalgia and anemia. Meanwhile, bradycardia was reported as a very common adverse effect, but generally asymptomatic, unlike the reported patient in this case report. This case report’s purpose is to increase awareness of the possibility of adverse effects due to alectinib administration that require immediate intervention in order to improve the quality of life and patient survival, especially in patients with advanced NSCLC.

References

PDQ Adult Treatment Editorial Board. Non-Small Cell Lung Cancer Treatment (PDQ®): Health Professional Version. 2020 Nov 19. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK65865/

Cersosimo RJ. Lung cancer: a review. Am J Health Syst Pharm. 2002;59(7):611-42. doi: 10.1093/ajhp/59.7.611. PMID: 11944603.

Elliott J, Bai Z, Hsieh SC, et al. ALK inhibitors for non-small cell lung cancer: A systematic review and network meta-analysis. PLoS One. 2020;15(2):e0229179. Published 2020 Feb 19. doi:10.1371/journal.pone.0229179

European Medicines Agency. Alecensa, INN-alectinib – European Medicines Agency [Internet]. 2018 Jul 05 [cited 2021 Jan 13]. Available from: https://www.ema.europa.eu/en/documents/product- information/alecensa-epar-product-information_en.pdf

Morcos PN, Bogman K, Hubeaux S, et al. Effect of alectinib on cardiac electrophysiology: results from intensive electrocardiogram monitoring from the pivotal phase II NP28761 and NP28673 studies. Cancer Chemother Pharmacol. 2017;79(3):559-68. doi: 10.1007/s00280-017-3253-5. Epub 2017 Feb 27. PMID: 28243683.

Food and Drug Administration. Alecensa (alectinib) – FDA) [Internet]. 2018 Jun [cited 2021 Jan 13]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/208434s004lbl.pdf

Bryson E, Ramalingam S, Beardslee T. Switching to an alternative ALK-inhibitor after alectinib- induced pneumonitis resulted in resolution of this adverse event. Current Problems in Cancer: Case Reports. 2020;2:100023. doi:10.1016/j.cpccr.2020.100023

Deng L, Sharma J, Ravera E, Halmos B, Cheng H. Hypersensitivity in ALK-positive lung cancers exposed to ALK inhibitors: a case of successful switch to an alternative ALK inhibitor and systematic review of the literature. Lung Cancer (Auckl). 2018;9:73-77. doi: 10.2147/LCTT.S173948. PMID: 30233266; PMCID: PMC6134951.

Odofin A, Wanogho J, Elsadany M, Kostela J, Mattana J. Mesalamine-associated sinus bradycardia. Am J Ther. 2019;26(6):e763-e764. doi: 10.1097/MJT.0000000000000932. PMID: 30883396.

Krzyzak M, Gupta A, Antonov E, et al. Mesalamine associated bradycardia. Cureus. 2018;10:e2425.

Asirvatham S, Sebastian C, Thadani U. Severe symptomatic sinus bradycardia associated with mesalamine use. Am J Gastroenterol. 1998;93:470–471.

Barquero-Romero J, Arrobas-Vacas J, López-Santamaría JL, et al. Sinus bradycardia associated with mesalazine. Med Clin (Barc). 2006;126:639.

Masarone D, Limongelli G, Rubino M, et al. Management of Arrhythmias in Heart Failure. J Cardiovasc Dev Dis. 2017;4(1):3. Published 2017 Feb 28. doi:10.3390/jcdd4010003

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Published

2022-07-07

How to Cite

Pitoyo, C. W., Rumende, C. M., Wiraputri, A. K., & Audita, F. R. (2022). Symptomatic Bradycardia Due to Alectinib in a Patient with Advanced Stage of NSCLC. Acta Medica Indonesiana, 54(2), 303. Retrieved from http://actamedindones.org/index.php/ijim/article/view/2095

Issue

Vol. 54 No. 2 (2022): Acta Medica Indonesiana

Section

CASE REPORT

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