Clinical features, diagnosis, and outcome of anaplastic lymphoma kinase tyrosine kinase inhibitors associated interstitial lung disease

Zhaoquan  Wu; Wei  Sun; Chunjiang Wang

doi:10.36141/svdld.2026.18699

Authors

Zhaoquan Wu changsha medical university
Wei Sun third xiangya hospital
Chunjiang Wang changsha medical university

Keywords:

anaplastic lymphoma kinase tyrosine kinase inhibitors, brigatinib, alectinib, lorlatinib, interstitial lung disease

Abstract

Background To investigate the clinical features of anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKI) -associated interstitial lung disease (ILD), and to provide a reference for the rational use of ALK TKI.

Methods Cases of ALK TKI-associated ILD before December 31, 2025 were collected by searching the database and clinical data were collected for retrospective analysis.

Result Fifty patients were included, with a median age of 54.5 years (range 33, 86). The median time of ILD occurrence was 50 days (range 2, 630). Dyspnea (56.0%), hypoxemia (38.0%), cough (36.0%) and fever (26.0%) were the main clinical symptoms, and there may also be no symptoms. Computed tomography mainly showed ground-glass opacities (98.0%). After the patients discontinued ALK-TKI and received systemic steroid treatment, 90.0% of the patients had symptom relief and improved imaging, and 10.0% of the patients died.

Conclusion ILD is a rare and fatal adverse event of ALK-TKI. The possibility of ILD should be considered if dyspnea, hypoxemia, and cough occur during ALK-TKI use. After ILD recovery, patients could switch to the same ALK-TKI or another ALK-TKI under the protection of glucocorticoid.

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