Severe Hepatotoxicity From Capmatinib: A Case Report and Therapeutic Approach

TL;DR

A patient with lung cancer developed severe liver damage from capmatinib and was successfully treated with NAC and ursodiol.

Contribution

Presents a novel therapeutic approach using NAC and ursodiol for capmatinib-induced liver injury.

Findings

Capmatinib caused grade 4 liver injury in a patient with MET exon mutated NSCLC.

N-acetyl cysteine and ursodeoxycholic acid therapy resolved the liver injury.

Drug discontinuation alone was ineffective in this case.

Abstract

Capmatinib, a selective mesenchymal-epithelial transition (MET)-kinase inhibitor, is approved for treating metastatic non-small cell lung cancer (NSCLC) with MET exon 14 (METex14) skipping mutation. Although a known side effect, not much data is available on the management of capmatinib-induced liver injury. Here, we present a case of a 60-year-old male with MET exon mutated NSCLC who developed grade 4 liver injury after capmatinib initiation, which did not respond to drug discontinuation and eventually responded to N-acetyl cysteine (NAC) and ursodeoxycholic acid (ursodiol) therapy. This case demonstrates that NAC plus ursodiol can be an effective treatment strategy in such patients.

Figures