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Case Report: Severe brigatinib-induced pneumonitis in a patient with EML4–ALK+ metastatic non-small cell lung adenocarcinoma

Year: 2025

Type: article

Abstract: Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs), such as brigatinib, are targeted therapies for metastatic non-small cell lung cancer (mNSCLC). We present a patient with echinoderm microtubule-associated protein-like 4 (EML4) and ALK fusion protein-positive mNSCLC who developed severe hypoxemia and pneumonitis requiring intubation within 2 days of initiating brigatinib therapy. The workup for alternative etiologies of respiratory distress was unrevealing, and the patient was treated for presumed brigatinib-induced pneumonitis with high-dose methylprednisolone. This case demonstrates high-grade, rapidly progressive brigatinib-induced pneumonitis with prompt clinical improvement after steroids and a marked disease response without recurring toxicity after treatment with an alternative ALK TKI, alectinib.

Source: Frontiers in Oncology

DOI: 10.3389/fonc.2025.1572425

Authors: Khyati Somayaji Dasika, Megan Melody, Jyoti D. Patel

Institutions: Northwestern University, Tampa General Hospital

Language: English

Topic: Lung Cancer Treatments and Mutations

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801