Explanation of why some patients are not recommended to take Crizotinib (Xalkori)

Crizotinib is one of the first targeted drugs approved for ALK-positive non-small cell lung cancer and has a significant effect on many patients. However, not all patients are suitable for this drug. The reasons why some patients are not recommended to take it are mainly related to the characteristics of the drug, the patient's own health condition, and the risk of potential adverse reactions. In clinical practice, doctors will comprehensively evaluate the safety of medication based on the patient's specific situation to avoid serious side effects or reduced drug efficacy.

First, patients with hepatic impairment are at higher risk when using crizotinib. Crizotinib is mainly metabolized by the liver. If the patient has abnormal liver function, such as cirrhosis, hepatitis or severe liver enzyme elevation, medication may cause the drug to accumulate in the body, increase the risk of hepatotoxicity, and even cause liver failure. Therefore, clinicians often use caution or adjust doses in patients with hepatic impairment or who are receiving other hepatotoxic drugs.

Secondly, patients with cardiovascular disease should use it with caution. Crizotinib may cause cardiovascular adverse reactions such as arrhythmia, QT interval prolongation, and hypotension. For patients with underlying heart disease, uncontrolled hypertension, arrhythmias, or a recent history of myocardial infarction, use of crizotinib may increase the risk of cardiovascular events. Doctors usually conduct electrocardiograms and cardiac function assessments before taking medication in such patients, and if necessary, strengthen monitoring or choose other treatment options.

In addition, crizotinib is not recommended for pregnant or breastfeeding women. Animal experiments show that crizotinib may have adverse effects on the fetus, and the drug can be secreted through breast milk, posing potential risks to infant health. Therefore, patients who are pregnant or planning to become pregnant should avoid using this drug and use effective contraceptive measures during treatment. Overall, although the efficacy of crizotinib is clear, patients with abnormal liver and kidney function, cardiovascular disease, or special physiological conditions should be used with caution based on physician evaluation to ensure safety and efficacy.

Reference:https://en.wikipedia.org/wiki/Crizotinib