Successful reintroduction of alectinib after acute kidney injury due to tubular toxicity in stage IV non-small cell lung cancer: a case report

Alectinib is the standard of care for patients with advanced ALK-rearranged non–small cell lung cancer (NSCLC). Although acute kidney injury (AKI) was not observed in pivotal alectinib trials, several case reports have described severe AKI associated with its use. We report a case of biopsy-proven tubular toxicity leading to AKI during alectinib treatment, followed by successful reintroduction after renal recovery. This case suggests that, in patients with alectinib-induced tubular toxicity, reintroduction of alectinib can be considered given its critical role in the treatment of ALK-positive advanced NSCLC.