ABSTRACT This report describes the first documented case of brigatinib‐induced pleuritis in a patient with ALK‐positive non‐small cell lung cancer. A 77‐year‐old woman developed dyspnoea, fever, elevated inflammatory markers, and bilateral pleural effusion shortly after starting brigatinib as third‐line therapy. Pleural fluid analysis showed lymphocyte‐predominant exudative effusion without evidence of malignancy or infection, suggesting drug‐induced pleuritis. Discontinuation of brigatinib led to rapid clinical and radiographic improvement. Although disease progression later occurred, pleuritis did not recur. Re‐administration of brigatinib at a reduced dose of 30 mg/day achieved tumour shrinkage without pleuritis recurrence, and subsequent dose escalation to 60 mg/day was also tolerated. This case highlights that clinicians should consider drug‐induced pleuritis when pleural effusion develops during brigatinib therapy, particularly when it is inconsistent with the disease progression. Dose reduction to as low as 30 mg/day may be a safe and effective therapeutic option for selected patients.
Yano et al. (Fri,) studied this question.