What are the precautions for Vebreltinib?

Vebreltinib is a new generation of highly selective MET tyrosine kinase inhibitor (MET-TKI), mainly used to treat MET exon 14 skipping mutations. mutation) non-small cell lung cancer (NSCLC) and some malignant tumors such as gliomas related to abnormalities in the MET signaling pathway. As a precision targeted therapy drug, bricitinib has shown significant potential in improving patient prognosis, but it also needs to comply with strict medication management practices. Understanding the precautions is of great significance to ensure efficacy, reduce adverse reactions and prolong survival benefits.

First of all, bricitinib is an oral targeted drug, and the medication must be taken strictly in compliance with the fasting principle. It is recommended to avoid eating at least 2 hours before a meal and half an hour after a meal, and only drink water. Food may affect the absorption rate and bioavailability of drugs, thereby changing drug concentrations in the body, resulting in unstable efficacy or enhanced toxicity. In addition, the medication time should be kept fixed, once in the morning and once in the evening, with an interval of about 12 hours, to maintain stable blood drug levels in the body. If the patient misses a dose, he or she should take it as soon as possible after discovery. However, if the next dose is less than 6 hours away, the dose should be skipped and the dose should not be taken again.

Secondly, boricitinib mainly relies on the CYP3A4 enzyme system in its metabolism. Therefore, simultaneous use with strong CYP3A4 inhibitors (such as ketoconazole, clarithromycin) or inducers (such as rifampicin, carbamazepine) should be avoided during medication. This type of drug may cause the blood concentration of bricitinib to be too high or too low, thus affecting the efficacy and safety. In addition, food or drinks containing grapefruit ingredients need to be used with caution, because grapefruit can inhibit CYP3A4 activity and increase drug exposure. If it is necessary to combine other drugs, the risk of drug interaction should be assessed under the guidance of a doctor.

In terms of liver function monitoring, boricitinib may cause liver injury manifestations such as elevated transaminases and abnormal bilirubin. Baseline liver function should be assessed before treatment and reexamined regularly during treatment. IfALT or AST exceeds 3 times the upper limit of normal, or is accompanied by clinical symptoms such as jaundice, loss of appetite, or worsening fatigue, the medication should be suspended or reduced immediately. In addition, patients should avoid drinking alcohol and using drugs that may damage the liver during treatment to reduce additive toxicity.

Cardiac safety is also an important concern when using drugs. Bripretinib can causeHeart rhythm changes such as QT interval prolongation, atrioventricular conduction abnormalities, etc., especially in patients with cardiovascular disease or electrolyte disorders, should be particularly cautious. It is recommended to conduct electrocardiogram testing before treatment and at the beginning of medication, and to monitor serum potassium and magnesium levels. If the patient develops heart palpitations, dizziness or syncope, they should seek medical attention immediately. For patients who are concurrently taking other drugs that affect the QT interval (such as antiarrhythmic drugs or some antibiotics), doctors should evaluate the risks before deciding whether to use the drugs together.

In terms of pulmonary-related risks, bricitinib may cause drug-induced interstitial pneumonia (ILD) or pneumonitis-like reactions. If the patient develops new or worsening symptoms such as cough, dyspnea, and chest tightness, the medication should be stopped immediately and imaging evaluation should be performed. After diagnosis of ILD, medication needs to be discontinued and glucocorticoid treatment is required. Although such adverse events are rare, if treatment is delayed, they may have serious consequences.

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