Talk to your doctor to see if ALECENSA following surgery is right for you.
Talk to your doctor to see if ALECENSA following surgery is right for you.
ALK+=positive for the biomarker called anaplastic lymphoma kinase; NSCLC=non-small cell lung cancer.
ALECENSA is an oral treatment for adults with non-small cell lung cancer (NSCLC) that is caused by an abnormal ALK gene. It can be used after surgery to help lower the chance of the cancer coming back, or as treatment if the cancer has already spread to other parts of the body.
ALECENSA is taken twice daily with food. The standard dose of ALECENSA is four 150-mg capsules. The total dose is 600 mg. You will take 2 doses of ALECENSA each day, for a total of 1200 mg (eight capsules). Take ALECENSA exactly as your doctor tells you to. Do not change your dose or stop taking ALECENSA unless your doctor tells you to. Your doctor may change your dose, temporarily stop, or permanently stop treatment with ALECENSA. Swallow ALECENSA capsules whole. Do not open or dissolve the capsule contents. For early-stage NSCLC, treatment may continue for up to 2 years, while for metastatic cases, therapy continues until your disease progresses or unacceptable side effects occur.
Serious side effects, such as liver problems (hepatoxicity), lung problems, kidney problems, slow heartbeat (bradycardia), severe muscle pain, tenderness, and weakness (myalgia), and breakdown of healthy red blood cells earlier than normal (hemolytic anemia), can occur and should be closely monitored. Common side effects of ALECENSA include constipation, tiredness, swelling in hands, feet, ankles, face, and eyelids, rash, and cough. Some individuals may also experience heightened sensitivity to sunlight.
| Criteria | ALECENSA dose modification |
|---|---|
| ALT or AST elevation of >5X ULN with total bilirubin ≤2X ULN | Temporarily withhold until recovery to baseline or to ≤3X ULN, then resume at reduced dose. See dose reduction schedule. |
| ALT or AST elevation >3X ULN with total bilirubin elevation >2X ULN in the absence of cholestasis or hemolysis | Permanently discontinue ALECENSA. |
| Total bilirubin elevation >3X ULN | Temporarily withhold until recovery to baseline or to ≤1.5X ULN, then resume at reduced dose. See dose reduction schedule. |
| Any grade treatment-related ILD/pneumonitis | Permanently discontinue ALECENSA. |
| Grade 3 renal impairment | Temporarily withhold until serum creatinine recovers to ≤1.5X ULN, then resume at reduced dose. See dose reduction schedule. |
| Grade 4 renal impairment | Permanently discontinue ALECENSA. |
| Symptomatic bradycardia | Withhold ALECENSA until recovery to asymptomatic bradycardia or to a heart rate of ≥60 bpm. If contributing concomitant medication is identified and discontinued, or its dose is adjusted, resume ALECENSA at previous dose upon recovery to asymptomatic bradycardia or to a heart rate of ≥60 bpm. If no contributing concomitant medication is identified, or if contributing concomitant medications are not discontinued or dose modified, resume ALECENSA at reduced dose upon recovery to asymptomatic bradycardia or to a heart rate of ≥60 bpm. See dose reduction schedule. |
| Bradycardiaa (life-threatening consequences, urgent intervention indicated) | Permanently discontinue ALECENSA if no contributing concomitant medication is identified. If contributing concomitant medication is identified and discontinued, or its dose is adjusted, resume ALECENSA at reduced dose upon recovery to asymptomatic bradycardia or to a heart rate of ≥60 bpm, with frequent monitoring as clinically indicated. Permanently discontinue ALECENSA in case of recurrence. See dose reduction schedule. |
| CPK elevation of >5X ULN | Temporarily withhold until recovery to baseline or to ≤2.5X ULN, then resume at same dose. |
| CPK elevation >10X ULN or second occurrence of CPK elevation of >5X ULN | Temporarily withhold until recovery to baseline or to ≤2.5X ULN, then resume at reduced dose. See dose reduction schedule. |
| Hemolytic anemia | Withhold ALECENSA if hemolytic anemia is suspected. Upon resolution, resume at reduced dose or permanently discontinue. See dose reduction schedule. |
aHeart rate <60 bpm.
ALT=alanine transaminase; AST=aspartate transaminase; bpm=beats per minute; CPK=creatine phosphokinase; ILD=interstitial lung disease; ULN=upper limit of normal.
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