Journal
JOURNAL OF ONCOLOGY PHARMACY PRACTICE
Volume 27, Issue 8, Pages 2010-2013Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/10781552211004698
Keywords
Lorlatinib; hyperlipidemia; minimal; change disease; nephrotic syndrome; non-small cell lung cancer
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A 63-year-old woman developed marked hyperlipidemia while on lorlatinib therapy and was diagnosed with minimal change disease. Management included assessments for nephrotic range proteinuria and renal biopsy to confirm the diagnosis for appropriate treatment.
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 63 year old woman with non-small cell lung adenocarcinoma on lorlatinib therapy develops marked hyperlipidemia. Management & outcome: 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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