Note: before purchasing and taking medicines, a hospital genetic test report and a doctor's diagnosis report or certificate must be produced
Brigatinib is a kinase inhibitor indicated for patients with anaplastic lymphoma kinase (ALK) - positive, crizotinib progressing or - intolerant metastatic non-small cell lung cancer (NSCLC).
(1) 90 mg once daily for the first 7 days; Increased thereafter to 180 mg daily if tolerated; Oral.
(2) May or may not be taken with food.
(1) Interstitial lung disease (ILD) / pneumonia: it occurred in 9.1% of patients at the recommended dose. Monitor for emerging or progressive respiratory symptoms, especially during the week of treatment. Brigatinib should be suspended for emerging or progressive respiratory symptoms and prompt evaluation for ILD / pneumonia. After recovery or dose reduction or discontinuation brigatinib.
(2) Hypertension: blood pressure was monitored during treatment for 2 weeks and then measured at least once a month. Brigatinib was suspended for severe hypertension and then dose reduced or discontinued.
(3) Bradycardia: regular monitoring of heart rate and blood pressure during treatment. Brigatinib was suspended if symptomatic, followed by dose reduction or discontinuation.
(4) Visual impairment: patient is advised to report visual symptoms. Brigatinib was suspended and ophthalmologic evaluation was performed if vision symptoms developed, late dose reduction was required, or brigatinib was discontinued.
(5) Creatine phosphokinase (CPK) increased: CPK levels were monitored regularly during treatment. Brigatinib was suspended with later dose resumption or dose reduction depending on severity.
(6) Elevated pancreatic enzymes: lipase and amylase levels were monitored regularly during treatment. Brigatinib was suspended with later dose resumption or dose reduction depending on severity.
(7) Hyperglycemia: fasting glucose was routinely assessed before and during brigatinib administration. Brigatinib was suspended if hyperglycemia could not be controlled, and later dose reduction or discontinuation was considered based on severity.
(8) Embryofetal toxicity: a possible fetal hazard. Females of reproductive age are counseled regarding the potential risks to the fetus, and the use of non hormonal effective contraception.
Common adverse events (≥ 25%) with brigatinib were nausea, diarrhea, fatigue, cough, and headache.
Drug drug interactions
(1) CYP3A inhibitors: avoid brigatinib concomitantly with strong CYP3A inhibitors. Brigatinib doses can be reduced if not avoidable.
(2) CYP3A inducers: avoid brigatinib concomitantly with strong CYP3A inducers.
(3) CYP3A substrates: hormonal contraceptives may not be effective due to a reduced exposure.