Key result
Lorlatinib therapy is linked to hyperlipidemia, possibly driven by minimal change disease.
Case Report (n=1)
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Lorlatinib-induced hyperlipidemia may be mediated by minimal change disease, highlighting the importance of a secondary hyperlipidemia workup in patients receiving cancer therapies.
INTRODUCTION: We report the case of a woman who developed hyperlipidemia on lorlatinib therapy found to have minimal change disease. We review therapies for cancer known to alter the lipid profile, in addition to reviewing secondary hyperlipidemia workup. We also propose a mechanism for lorlatinib-induced hyperlipidemia. CASE REPORT: A secondary hyperlipidemia workup is performed which reveals nephrotic range proteinuria. Minimal change disease is found on renal biopsy. The hyperlipidemia was initially responsive to statin therapy, then required addition of ezetimibe. DISCUSSION: This is a case of hyperlipidemia in a patient on lorlatinib. The case highlights that therapies for lung cancer and other malignancies have the potential to alter the lipid profile. We propose minimal change disease as a possible mechanism for lorlatinib-induced dyslipidemia. Additionally, we discuss the crucial aspects of secondary hyperlipidemia workup.
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McGee et al. (2021) conducted a case report in Metastatic non-small cell lung cancer (n=1). Lorlatinib was evaluated on Hyperlipidemia. Lorlatinib therapy was associated with hyperlipidemia in a patient with metastatic non-small cell lung cancer, with minimal change disease proposed as a possible mechanism.
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