Renal cyst formation complicating ALK inhibitors

With rapid discovery of oncogenic deriver genes over the past decade, several tyrosine kinase inhibitors (TKIs) were developed to target the anaplastic lymphoma kinase (ALK) aberration in non-small cell lung cancers (NSCLCs), including first, second and third-generation ALK inhibitors for ALK-rearranged NSCLC treatment. However with recent data published from several clinical trials and retrospective studies investigating the efficacy of these TKIs in ALK-rearranged NSCLC patients, development of renal cysts is a side effect associated with first generation TKI crizotinib; the mechanism for cyst formation, and whether it is a class effect, is unclear. In this review we will summarize published data on development of kidney injury and renal cysts associated with ALK inhibitors with focus on crizotinib-related renal cysts.