Alectinib-induced anemia with acanthocytosis: To proceed or discontinue treatment in Non-Small Cell Lung Cancer patients?

Abstract

ALK gene rearrangements are important oncogenic driver alterations in non-small-cell lung cancer and a predictive factor. When present, it enables the use of tyrosine kinase inhibitors, such as Alectinib. This drug can lead to anemia and erythrocyte morphological changes. We present the case of a 72-year-old patient diagnosed with stage IV non-small cell lung cancer treated with Alectinib in the first line. The drug was very effective in reducing the tumor size but with G2 anemia and acanthocytosis as side effects. Anemia was improved once Alectinib was replaced by Brigatinib.