Rationale: Crizotinib is a multi-target small molecule tyrosine kinase inhibitor that specifically targets anaplastic lymphoma kinase, mesenchymal-epithelial transition factor/hepatocyte growth factor receptor, and c-ROS oncogene 1 (ROS1). Its primary application in clinical settings is for the treatment of advanced non-small-cell lung cancer characterized by anaplastic lymphoma kinase-positive and/or ROS1 fusion gene-positive status. Hyperlipidemia is a rarely documented adverse reaction to crizotinib, with its underlying mechanisms and clinical management strategies remaining unclear. Patient concerns: Significant dyslipidemia was observed in a 70-year-old female with advanced, ROS1 fusion-positive lung adenocarcinoma during crizotinib therapy. Diagnoses: This case report presents a patient diagnosed with advanced lung adenocarcinoma harboring an ROS1 fusion gene, who subsequently developed severe hyperlipidemia during treatment with the targeted agent crizotinib. Interventions: A combined strategy of crizotinib dose reduction and concomitant lipid-lowering therapy was initiated to address the hyperlipidemia, aiming to maintain control of the primary malignancy while managing the adverse effect. Outcomes: Following a reduction in the dosage of crizotinib and the implementation of proactive lipid-lowering interventions, both the malignancy and the associated adverse effects were effectively controlled. Lessons: The condition exhibited a typical positive rechallenge feature of “discontinuation and recurrence,” providing critical clinical evidence to establish this causal relationship. The case aims to enhance the understanding of crizotinib’s metabolic side effects, underscores the importance of dynamic lipid monitoring, and offers empirical support for the standardized management of such rare adverse reactions.
Ren et al. (2026) studied this question.