Lorlatinib-induced focal segmental glomerulosclerosis: The first case described in literature

A third-generation anaplastic lymphoma kinase (ALK) inhibitor, lorlatinib, plays a crucial role in the management of ALK-rearranged non-small cell lung cancer. The renal effects of the drug are not yet clear. Herein we report the first case of focal segmental glomerulosclerosis (FSGS) associated with lorlatinib in a 64-year-old male diagnosed with stage IV ALK-rearranged lung adenocarcinoma. This is the first case of FSGS, confirmed by kidney biopsy, described in literature in patient treated with lorlatinib. This case shows a potential kidney effect of lorlatinib, suggesting the importance of monitoring proteinuria and kidney function during therapy, to perform a kidney biopsy in these patients to understand the underlying mechanisms of damage and highlight the importance of close cooperation between oncologist and nephrologist in the clinical management of these frail patients.