Published online May 6, 2019. doi: 10.12998/wjcc.v7.i9.1080
Peer-review started: December 27, 2018
First decision: January 30, 2019
Revised: February 25, 2019
Accepted: March 8, 2019
Article in press: March 8, 2019
Published online: May 6, 2019
Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old Asian patient.
The patient complained of dyspnea and upper abdominal pain for a week in August 2017. He was diagnosed with anaplastic lymphoma kinase-rearranged lung adenocarcinoma combined with multiple distant metastases. Crizotinib was initiated as a first-line treatment at a dosage of 250 mg twice daily. No adverse effects were seen until day 46. On day 55, he was admitted to the hospital with elevated liver enzymes aspartate aminotransferase (AST) (402 IU/L), alanine aminotransferase (ALT) (215 IU/L) and total bilirubin (145 μmol/L) and was diagnosed with crizotinib-induced fulminant liver failure. Despite crizotinib discontinuation and intensive supportive therapy, the level of AST (1075 IU/L), ALT (240 IU/L) and total bilirubin (233 μmol/L) continued to rapidly increase, and he died on day 60.
Physicians should be aware of the potential fatal adverse effects of crizotinib.
Core tip: Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop to fatal liver failure. We report a case of fatal crizotinib-induced liver failure in a 37-year-old Asian patient with anaplastic lymphoma kinase-rearranged lung adenocarcinoma combined with hepatic metastasis. Physicians should be aware of the potential fatal adverse effect of crizotinib. The King’s College Criteria and weekly monitoring of liver enzymes are necessary to diagnose and evaluate crizotinib-induced liver failure.