Pharmacokinetics of alectinib and its metabolite M4 in a patient with advanced lung adenocarcinoma undergoing hemodialysis: A case report

This study presents the first detailed pharmacokinetic data of alectinib and its metabolite M4 in a patient with anaplastic lymphoma kinase (ALK)-rearranged lung adenocarcinoma undergoing hemodialysis. When the patient was administered a daily 300 mg bid dose of alectinib, the maximal observed plasma concentration (C_max) of alectinib and M4 were 638 and 82 ng/ml, respectively, at steady-state (day 9). These pharmacokinetic data were similar to those previously reported in patients with normal organ function. The trough plasma concentration (C_trough) of alectinib and M4 on the hemodialysis day were 562 and 66 ng/ml, respectively, identical to those on post-hemodialysis day. He remains well and in partial remission 12 months after his diagnosis. We believe that alectinib is feasible and effective for patients with ALK-rearranged non-small cell lung cancer undergoing hemodialysis.