Meta Description:
Alectinib is a targeted therapy used primarily to treat ALK positive non small cell lung cancer NSCLC Learn about its uses dosage mechanism of action potential side effects drug interactions clinical studies and patient considerations in this comprehensive guide
Introduction
Alectinib is an oral targeted anticancer medication belonging to the class of tyrosine kinase inhibitors It is specifically designed to inhibit anaplastic lymphoma kinase ALK and is primarily used for the treatment of ALK positive metastatic non small cell lung cancer NSCLC Alectinib is considered a second generation ALK inhibitor and is often prescribed when patients show resistance or intolerance to earlier ALK inhibitors such as crizotinib
Medical Uses
The primary indication of alectinib is for patients with metastatic ALK positive NSCLC It can be used as a first line therapy in newly diagnosed patients or as a second line treatment for those who have progressed on previous ALK inhibitors Clinical studies have shown that alectinib provides prolonged progression free survival and significantly reduces the risk of brain metastases compared to older agents
Mechanism of Action
Alectinib selectively targets and inhibits the ALK receptor tyrosine kinase By blocking this abnormal signaling pathway it prevents cancer cell growth and proliferation This targeted approach allows for more effective tumor control with fewer off target effects compared to traditional chemotherapy Additionally alectinib has good penetration across the blood brain barrier making it effective against brain metastases
Dosage and Administration
The usual recommended dosage of alectinib for adults is 600 mg taken orally twice daily with food The tablets should be swallowed whole without crushing or chewing Treatment continues until disease progression or unacceptable toxicity occurs Dose adjustments may be required based on patient tolerance and liver function
Side Effects
Common side effects of alectinib include
Fatigue
Constipation
Muscle pain
Edema particularly in the hands and feet
Increased liver enzymes
Serious adverse effects can include hepatotoxicity interstitial lung disease bradycardia and severe muscle related problems Liver function tests and other clinical monitoring are essential throughout therapy
Drug Interactions
Alectinib is metabolized primarily by the CYP3A enzyme system Caution is advised when coadministered with strong CYP3A inhibitors or inducers as these may affect the drug’s plasma levels Grapefruit and grapefruit juice should be avoided as they can increase drug concentration leading to toxicity
Contraindications and Precautions
Alectinib is contraindicated in patients with known hypersensitivity to the drug or any of its components Special precautions are needed in patients with preexisting liver disease or bradycardia Regular monitoring of heart rate liver function and creatine phosphokinase levels is recommended
Clinical Studies and Efficacy
Multiple clinical trials have demonstrated the superior efficacy of alectinib compared to crizotinib in both treatment naïve and previously treated ALK positive NSCLC patients In the ALEX trial alectinib significantly improved progression free survival and reduced the incidence of central nervous system progression making it a preferred first line option
Pregnancy and Lactation
There is limited data on the use of alectinib during pregnancy It may cause fetal harm based on animal studies Women of childbearing potential should use effective contraception during treatment and for a period after the last dose Breastfeeding is not recommended during treatment with alectinib and for some time afterward due to potential adverse effects on the infant
Overdose
No specific antidote exists for alectinib overdose Supportive care and symptomatic treatment should be provided in such cases
Conclusion
Alectinib represents a major advancement in the treatment of ALK positive NSCLC Its targeted mechanism long duration of response and ability to cross the blood brain barrier make it a preferred treatment option for many patients Proper monitoring of liver function cardiac status and drug interactions is essential to ensure safety and effectiveness
