Successful tolerance of a third-generation tyrosine kinase inhibitor after alectinib-induced lung injury: A case report

Targeted therapies, particularly anaplastic lymphoma kinase tyrosine kinase inhibitors (ALK-TKIs), have revolutionized the treatment of ALK-positive non-small cell lung cancer (NSCLC). Lung cancer represents the third most commonly diagnosed malignancy in the United States in 2024.ALK inhibitors, including the first-generation ALK tyrosine kinase inhibitor (ALK-TKI) crizotinib, the second-generation ALK-TKI alectinib, and the third-generation ALK-TKI lorlatinib, have demonstrated remarkable efficacy in treating ALK-positive non small-cell lung cancer. We present a case of a 46-year-old African American patient who developed grade 3 pneumonitis after initiating alectinib treatment. Following discontinuation of alectinib and treatment of the pneumonitis, the patient was successfully transitioned to lorlatinib, which was well-tolerated without recurrence of pneumonitis or other adverse events.