Multidisciplinary Management Of Alecensa-Induced Gingival Overgrowth

Alecensa is an effective targeted therapy for ALK-positive non-small cell lung cancer (NSCLC). Gingival overgrowth as a rare oral side effect of Alecensa remains underreported. This case emphasizes the importance of interdisciplinary collaboration in early identification and effective management to maintain both oral health and continuity of cancer treatment. A 46-year-old female diagnosed with stage IV (T4N3M1a) ALK-positive adenocarcinoma of the lower right lung developed generalized gingival overgrowth (>4 mm, Hassell Grade III) after six months of Alecensa treatment. Symptoms included difficulty maintaining oral hygiene, gingival discomfort, and bleeding during brushing. After comprehensive dental assessment, conservative multidisciplinary management involving professional scaling andgingivectomy, accompanied by 0.12% chlorhexidine rinses and oral hygiene reinforcement, was implemented. At three-month follow-up, significant improvement was observed with no recurrence. Drug-induced gingival overgrowth (DIGO) commonly occurs with immunosuppressants and calcium channel blockers but is rarely reported with Alecensa. The mechanism may involve altered ALK signaling pathways affecting fibroblast proliferation and collagen metabolism. Since Alecensa therapy is crucial for managing NSCLC, discontinuation is typically not viable. Early recognition, along with interdisciplinary collaboration between oncologists and dentists, ensures timely and effective management without compromising oncologic treatment. This case underscores the importance of routine dental monitoring in patients receiving Alecensa. Interdisciplinary collaboration enables early intervention, improving oral health outcomes and patient quality of life during cancer therapy.