HOME  >  Online journal

Vol.63 No.7 contents

Japanese/English

Full Text of PDF (432K) Article in Japanese

- Case Report -

A Case of Severe Psychosis Associated with Lorlatinib

Kei Kunimasa¹, Makoto Wada², Noriaki Matsushima³, Motohiro Tamiya¹, Takako Inoue¹, Takahisa Kawamura¹, Akito Miyazaki¹, Kazumi Nishino^1
1Department of Thoracic Oncology, ²Department of Psycho-Oncology and Palliative Medicine, Osaka International Cancer Institute, Japan, ³Department of Psychology, Hannan Hospital, Japan

---

Background. Lorlatinib has shown excellent antitumor activity and central nervous system metastases control. We herein report a lung adenocarcinoma patient harboring ALK fusion who developed severe psychotic symptoms due to lorlatinib. Case. A 32-year-old never-smoking man was diagnosed with advanced lung adenocarcinoma harboring ALK fusion. He had no history of psychosis. He had been treated with alectinib for five years and six months. When lorlatinib was introduced as second-line treatment after tumor progression was observed due to cancerous meningitis, he developed a mild confusional state on day 8 of treatment, and on day 9, he threw himself from his third-floor apartment in an acute confusional state with visual and auditory hallucinations. Luckily, no high-energy trauma was observed. The patient showed improvement after withdrawal of lorlatinib and inward treatment at a psychiatric hospital, including anti-psychotic drug administration. Since the patient had no history of psychosis and had shown no similar symptoms during five years of hospitalization, we diagnosed him with a Grade 4 psychiatric disorder induced by lorlatinib. Conclusion. Although extremely rare, lorlatinib can cause serious psychiatric symptoms. Adequate explanation of this possibility is required at the time of induction, and if severe psychiatric symptoms are observed, collaboration with a psychiatrist is necessary.
key words: ALK fusion, ALK inhibitor, Lorlatinib, Psychiatric disorder, Psychosis

Received: August 25, 2023
Accepted: September 9, 2023

JJLC 63 (7): 983-987, 2023