Pemetinib (Dabotan) tablet instructions for usage, dosage and precautions

Pemigatinib is an oral selective FGFR (fibroblast growth factor receptor) inhibitor. It is mainly used to treat patients with cholangiocarcinoma carrying FGFR2 gene fusions or rearrangements. It can also be used as a targeted therapy in some FGFR-related tumors. Its mechanism of action is to inhibit tumor cell proliferation and angiogenesis by inhibiting the FGFR signaling pathway, thereby slowing down disease progression. The use of pemetinib requires strict compliance with usage, dosage and precautions to ensure the efficacy and safety of the drug.

According to the official instructions, the recommended standard dose of pemetinib tablets is 13.5mg taken orally once a day, with a cycle of three weeks of oral administration and one week of rest (21 days of medication+7 days of rest). During initial treatment, the recommended dose should be started and adjusted individually based on the patient's tolerance and serum phosphorus levels. For patients with impaired liver and kidney function, especially those with moderate or severe liver dysfunction, the dose needs to be carefully evaluated, and the dose can be reduced or the interval extended if necessary to reduce the risk of adverse reactions. Patients should take it on an empty stomach or with food, but they need to avoid taking it with drugs that strongly change pH to avoid affecting absorption.

Common adverse reactions of pemetinib include hyperphosphatemia, stomatitis, diarrhea, fatigue and alopecia, among which hyperphosphatemia is a characteristic adverse event of FGFR inhibitors. Monitoring of blood phosphorus levels is particularly important. It is recommended that patients regularly detect blood phosphorus and electrolytes such as calcium and magnesium before the start of treatment and during treatment, and adjust their diet, use phosphorus binders or make dose adjustments based on the results. In addition, liver function, kidney function and blood routine indicators also need to be monitored regularly to detect and deal with potential toxicity in a timely manner.

In terms of drug safety, pemetinib has potential cardiovascular risks, such as QT interval prolongation. Therefore, electrocardiogram evaluation should be performed before starting treatment. Patients with abnormal heart rhythm or using other QT prolonging drugs should be used with caution. If serious adverse reactions occur during medication, such as uncontrollable hyperphosphatemia, persistent diarrhea, or significant abnormalities in liver function, you should consider suspending or reducing the dose and handle it under the guidance of a professional doctor.

The medication cycle and dose adjustment of pemetinib need to be flexibly adjusted based on the patient's specific conditions. If moderate adverse reactions occur, treatment can be temporarily interrupted and the original dose can be restored or the dose can be reduced to continue treatment after symptoms are relieved. For serious or life-threatening adverse events, the drug should be discontinued immediately and necessary medical intervention should be carried out. In addition, patients should maintain adequate fluid intake while taking the medication, pay attention to a balanced diet, and reduce the intake of high-phosphorus foods to help control blood phosphorus levels.

For pregnant and lactating women, pemetinib is a drug with potential teratogenic risk, so it is prohibited or used under strict risk assessment. Women of childbearing age should take effective contraceptive measures during treatment and continue to do so for at least a certain period of time after treatment ends. Male patients should also avoid passing drugs through semen to affect their partner's pregnancy during medication.

In general, pemigatinib (Pemigatinib), as a targeted therapy for FGFR2 mutated cholangiocarcinoma, has clear efficacy, but medication management must strictly follow the instructions for usage, dosage and precautions. Through individualized dose adjustment, regular monitoring of serum phosphorus and liver and kidney function, timely handling of adverse reactions, and compliance with safe medication principles, drug efficacy can be maximized while treatment risks are reduced. Patients should maintain close communication with the professional medical team throughout the entire treatment process to ensure the scientificity and safety of the treatment plan.

In the future, with the accumulation of more clinical data and real-world evidence, the optimization of the treatment course, combination treatment strategy and long-term safety of pemetinib will be clearer, providing more precise and effective treatment options for patients with cholangiocarcinoma carrying FGFR2 mutations. When formulating treatment plans, doctors should take into account the patient's condition, concomitant diseases and individual tolerance to achieve the best clinical benefit of targeted therapy.

Keyword tags: pemetinib, FGFR inhibitor, cholangiocarcinoma, usage and dosage, adverse reactions

Reference materials:https://pmc.ncbi.nlm.nih.gov/articles/PMC9991984/