Not a real patient.
ALECENSA is not a traditional chemotherapy. It works differently than chemotherapy. ALECENSA is an oral treatment known as an ALK inhibitor. ALK inhibitors like ALECENSA are thought to work by blocking the ALK protein responsible for the growth and spread of ALK+ NSCLC. This is important to know because the type of cancer you have, ALK+ NSCLC, may be treated by medications that target ALK.
ALECENSA is prescribed for 2 different groups of people:
For certain people with early-stage non-small cell lung cancer (eNSCLC), it's used as an adjuvant treatment after surgery. The goal of treatment after surgery is to help keep you disease-free for longer.
It's also used as a treatment for newly diagnosed people whose tumors have spread, also known as metastatic non-small cell lung cancer (mNSCLC).
You have likely either just completed surgery for your ALK+ eNSCLC or are scheduled to get surgery soon. Surgery is very important because it removes the visible tumor(s). But sometimes, there are hidden, microscopic cancer cells that weren't seen or found during surgery. Those microscopic cells can turn into a cancer recurrence. Sometimes cancer comes back, even after a successful surgery. Adjuvant treatment is an additional step you and your doctor can take to help lower the chance of that happening.
ALK inhibitor: An ALK inhibitor is a type of medicine that is designed to bind to and block the activity of the ALK protein.
ALK+ NSCLC: ALK (anaplastic lymphoma kinase positive) non-small cell lung cancer is a type of lung cancer involving the mutation of the ALK gene.
Adjuvant treatment: Treatment given after surgery to help lower the risk that cancer will come back.
Metastatic non-small cell lung cancer (mNSCLC): This means that the cancer has started to spread. It’s also called advanced lung cancer, or stage 4.
Recurrence: This is when cancer comes back after surgery or treatment.
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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