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Revisiting a lower starting dose of alectinib in ALK-Positive non-small cell lung cancer.
- Source :
-
Cancer treatment and research communications [Cancer Treat Res Commun] 2021; Vol. 27, pp. 100319. Date of Electronic Publication: 2021 Jan 23. - Publication Year :
- 2021
-
Abstract
- We present here a case of ALK-positive lung adenocarcinoma that has been started on Alectinib. Treatment has been initiated at the recommended initial dose, but it subsequently required a dose adjustment following adverse drug events. Alectinib is a second-generation, CNS-active, tyrosine kinase inhibitor used in the treatment of ALK-positive non-small cell lung cancer. Its efficacy as a first-line treatment and as a second-line agent after Crizotinib has been proven across several trials both in terms of overall response rate and progression-free survival. The use of Alectinib is associated with side effects that occasionally lead to treatment discontinuation, interruption, or dose adjustment. Several studies have used two starting doses - 300 mg and 600 mg twice daily - across different populations and have consistently shown efficacy of Alectinib for both treatment doses. Results of these studies have also revealed that body weight, rather than race, affect the pharmacokinetics of Alectinib. Randomized trials have shown that the 600 mg dose is associated with more grade ≥3 adverse events and more changes in treatment in contrast to the 300 mg dose. A lower dose of Alectinib may limit treatment disruptions and dose reductions particularly for specific patient populations-particularly those with a lower body weight.<br /> (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Subjects :
- Anaplastic Lymphoma Kinase antagonists & inhibitors
Carbazoles adverse effects
Carcinoma, Non-Small-Cell Lung genetics
Carcinoma, Non-Small-Cell Lung mortality
Crizotinib administration & dosage
Crizotinib adverse effects
Dose-Response Relationship, Drug
Drug Administration Schedule
Humans
Lung Neoplasms genetics
Lung Neoplasms mortality
Lung Neoplasms pathology
Piperidines adverse effects
Progression-Free Survival
Protein Kinase Inhibitors adverse effects
Randomized Controlled Trials as Topic
Anaplastic Lymphoma Kinase genetics
Carbazoles administration & dosage
Carcinoma, Non-Small-Cell Lung drug therapy
Lung Neoplasms drug therapy
Piperidines administration & dosage
Protein Kinase Inhibitors administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 2468-2942
- Volume :
- 27
- Database :
- MEDLINE
- Journal :
- Cancer treatment and research communications
- Publication Type :
- Academic Journal
- Accession number :
- 33515938
- Full Text :
- https://doi.org/10.1016/j.ctarc.2021.100319