Amivantamab-associated capillary leak syndrome presenting with severe anasarca and profound hypoalbuminaemia in metastatic non-small cell lung cancer
Year: 2026
Type: article
Study design: Case Report
Abstract: Amivantamab, a bispecific EGFR–MET (Epidermal Growth Factor-Mesenchymal-Epithelial Transition Factor) antibody, is increasingly used in advanced non-small cell lung cancer (NSCLC) and is associated with MET-related adverse events, including peripheral oedema and hypoalbuminamia. We report the case of a woman in her early 70s with metastatic EGFR-positive NSCLC who developed rapidly progressive anasarca, acute kidney injury and profound hypoalbuminaemia immediately after the first dose of amivantamab. Extensive evaluation excluded cardiac failure, nephrotic syndrome, hepatic disease, protein-losing enteropathy, infection, autoimmune disease, plasma cell dyscrasia and tumour progression. Discontinuation of amivantamab and treatment with scheduled intravenous albumin combined with loop diuretics resulted in complete clinical and biochemical recovery, sustained at 6-month follow-up while continuing osimertinib. This case represents a severe manifestation of amivantamab-associated fluid retention and supports the recognition of a drug-induced capillary leak phenotype.
Source: BMJ Case Reports
Authors: Carmi Bartal, Julia Dudnik, Aya Biderman
Institution: Ben-Gurion University of the Negev
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7224193380