Indications and medication precautions for the Lao bear version of Brigatinib
Brigatinib is a targeted therapy for ALK positive non-small cell lung cancer, with clear indications and multiple precautions to be taken when using it. The following explanation covers clinical key information and risk management points from two aspects: indications and medication precautions.
1. Indications
(1) The first-line treatment for ALK positive metastatic non-small cell lung cancer (NSCLC) is suitable for patients with ALK rearrangement confirmed by FDA approved testing methods.
(2) Second line treatment for ALK positive metastatic NSCLC patients who have progressed or become intolerant after previous treatment with Crizotinib.
2. Medication precautions
(1) Interstitial lung disease/pneumonia
In the early stages of treatment (usually within one week), fatal interstitial lung disease may occur, and new or worsening symptoms such as dyspnea and cough need to be monitored. If symptoms appear, the medication should be stopped immediately and glucocorticoid treatment should be given.
(2) Hypertension
About 21% of patients develop grade 3 hypertension, and regular monitoring of blood pressure is required during medication. Hypertension of grade 2 or above requires initiation of antihypertensive treatment, while grade 3 requires suspension of medication until it recovers to below grade 1.
(3) Bradycardia
May cause symptomatic bradycardia and increase the risk of combined use with antihypertensive drugs. Regularly monitor heart rate and blood pressure, and adjust concomitant medication or reduce the dose of brigatinib if symptomatic bradycardia occurs.
(4) Visual impairment
About 10% of patients experience blurred vision, diplopia, or decreased vision. It is recommended to undergo ophthalmic examination at baseline and when symptoms appear. If the symptoms persist or worsen, consider reducing or stopping the medication.
(5) Elevated creatine phosphokinase
About 27% of patients experience grade 3-4 CPK elevation and require monitoring for muscle pain or weakness symptoms. Medication should be suspended for levels 3 and above until it returns to level 1 or below, and can be reduced and restarted thereafter.
(6) Elevated pancreatic enzymes
May cause an increase in amylase/lipase, pancreatic enzyme levels need to be monitored monthly. Medication should be suspended for levels 3 and above until it returns to below level 1.
(7) High blood sugar
It may aggravate existing diabetes or induce new hyperglycemia, and blood glucose should be monitored regularly. Uncontrollable grade 3 hyperglycemia requires temporary suspension of medication until improvement.
(8) Embryo fetal toxicity
Animal studies have shown teratogenicity, and women of childbearing age should take effective contraceptive measures during treatment and within 4 months after discontinuing medication. Prohibited during pregnancy, breastfeeding should be stopped during lactation.
Disclaimer：《Indications and medication precautions for the Lao bear version of Brigatinib》Edited and sorted by Seagull Pharmacy's editors. Please contact us in time if there is any infringement. In addition, the suggestions for drug usage, dosage and disease mentioned in the article are only for medical staff's reference, and can not be used as any basis for medication！