A brief introduction to the precautions and contraindications of the anaplastic lymphoma kinase (ALK)-positive lung cancer drug alectinib

Introduction: Alectinib is a targeted drug for the treatment of non-small cell lung cancer, especially suitable for patients with anaplastic lymphoma kinase (ALK)-positive locally advanced or metastatic non-small cell lung cancer. Alectinib needs to be taken under the guidance of a doctor experienced in the use of anti-tumor drugs. This article mainly talks about the precautions, medication contraindications, mechanism of action, experimental efficacy, medication contraindications and dietary precautions of aletinib.

Precautions

Children, pregnant women, lactating women and the elderly should use it under the guidance of a doctor. Liver function, including ALT, AST, and total bilirubin, should be monitored early in treatment, and renal function should be monitored regularly. Symptomatic bradycardia may occur during alectinib treatment, and heart rate and blood pressure should be monitored as clinically indicated. Photosensitivity to sunlight has been reported during alectinib treatment, and it is recommended to use sunscreen and avoid prolonged sun exposure. Always talk to your doctor before taking other medicines (including over-the-counter medicines, vitamins, and herbal medicines) with them.

Mechanism of action

The main mechanism of action of alectinib includes inhibition of the EGFR signaling pathway, anti-tumor effects and targeted therapy. It can prevent the binding of EGFR to ligands, inhibit cell growth and proliferation; inhibit the growth of tumor cells and promote the apoptosis of tumor cells; by selectively acting on specific targets in tumor cells, it can reduce the toxic side effects on normal cells and improve the therapeutic effect.

Trial Efficacy

Alectinib has shown significant efficacy in the treatment of ALK-positive advanced non-small cell lung cancer. In the ALEX study, as first-line treatment, the median progression-free survival (PFS) of aletinib reached 34.8 months, far exceeding the 10.9 months of existing standard treatment drugs. Alectinib can effectively break through the blood-brain barrier and reduce the risk of brain metastasis in patients by 84%. Among patients who have already developed brain metastases at the time of diagnosis, the progression-free survival is still as long as 27.7 months after first-line use of alectinib. Compared with chemotherapy, aletinib has fewer side effects and improves patients' quality of life.

Drug Contraindications

Alectinib is contraindicated in patients with severe heart problems. Avoid grapefruit and grapefruit juice. It is contraindicated in patients allergic to alectinib or any excipients. It is recommended that lactating women stop breastfeeding while taking this product. There may be other contraindications included in the instructions, and patients should follow the doctor's guidance and the recommendations in the drug instructions.

Dietary attention

The drug exposure after taking aletinib with a high-fat, high-calorie meal is three times higher than taking the drug on an empty stomach, so it is recommended that patients take it with a meal. A low-fat diet may reduce drug exposure to alectinib and affect its efficacy. Patients taking should avoid reducing fat intake in meals taken with the drug. It is recommended that food with meals must contain sufficient fat. Patients are advised to eat more easily digestible foods, vegetables and fruits, and drink plenty of water to help with drug absorption and reduce gastrointestinal discomfort. Since different patients have different dietary habits and structures, individualized dietary advice may be needed to ensure optimal efficacy of the drug.