Vinay Saggar and Andrew Restivo
AL 3818 (Anlotinib, Catequentinib), a novel multi-target tyrosine kinase inhibitor that is administered orally, is recently undergoing phase Ib/IIa trials in patients with recurrent or metastatic endometrial, ovarian or cervical carcinoma3. This is a case of a patient with stage IIIA2 serous ovarian adenocarcinoma who accidentally ingested twelve times the desired amount of Advenchen AL3818/anlotinib. The patient’s initial ED resuscitation strategy revolved around intravenous fluids, prompt administration of activated charcoal, and coordination of an endoscopic retrieve attempt which was ultimately unsuccessful. The patient subsequently developed downstream sequela of acute renal injury and stress-related taksubo cardiomyopathy. Although just one case–and to our knowledge the first of its kind–of Advenchen AL3818/anlotinib overdose, this report suggests these patients should have a wide array of “screening” labs sent and strong consideration for prolonged observation periods given the potential of delay complications that can arise.