Organizing pneumonia resembling disease progression in a non-small-cell lung cancer patient receiving ceritinib: A case report

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Abstract

Rationale:

Echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK), a distinct molecular entity, is highly sensitive to ALK tyrosine kinase inhibitors (TKIs) such as crizotinib or ceritinib. Interstitial lung disease is a rare (1.2%) pulmonary toxicity that can result from ALK TKIs, however, organizing pneumonia has not been reported to date.

Patient concerns:

A 45-year-old Korean female with ALK-rearranged metastatic lung adenocarcinoma underwent ceritinib treatment and exhibited a partial response, until she developed organizing pneumonia resembling disease progression.

Diagnoses:

Multiple rebiopsies confirmed the involvement of organizing pneumonia in the pathology.

Interventions:

Ceritinib was stopped and the patient was treated with intravenous antibiotics followed by oral antibiotics for two weeks.

Outcomes:

After recovering from organizing pneumonia, ceritinib was successfully rechallenged and the patient attained a complete response.

Lessons:

When a new mass-like lesion develops in the lungs of responding patients, benign lung conditions, including organizing pneumonia should be considered in differential diagnoses.

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