Management of ceritinib therapy and adverse events in patients with ALK-rearranged non-small cell lung cancer.
Affiliation
The Christie Hospital NHS Foundation Trust and University Hospital of South Manchester NHS Foundation Trust, ManchesterIssue Date
2017-09
Metadata
Show full item recordAbstract
Anaplastic lymphoma kinase rearrangement (ALK+) occurs in approximately 2-7% of patients with non-small cell lung cancer (NSCLC), contributing to a considerable number of patients with ALK+ NSCLC worldwide. Ceritinib is a next generation ALK inhibitor (ALKi), approved by the European Medicines Agency in 2015. In the first-in-human, phase I study, ceritinib demonstrated rapid and durable responses in ALK patients previously treated with a different ALKi and in those who were ALKi-naive. As ceritinib is starting to be used routinely for the treatment of patients with ALK+ NSCLC, experience is growing with regard to ideal therapy management. In this review we provide a brief background to the development of ceritinib. The optimal treatment management and adverse events associated with ceritinib in clinical trials and in clinical practice are then discussed in detail, and where applicable, an expert consensus on specific recommendations are made. In clinical trials, the most common adverse events related to ceritinib are nausea, vomiting, and diarrhea. However, the majority of these are mild and, in the opinion of the authors, can be effectively managed with dose modifications. Based on clinical data, ceritinib has demonstrated efficacy as a first-line therapy and in patients who have relapsed on crizotinib, including those with brain metastases at baseline. Unfortunately, at some point, all patients experience progressive disease, with the central nervous system being a common site of metastases. Recommendations are made for continuing treatment beyond disease progression as long as a clinical benefit to patients is observed. Here, we review management of ceritinib treatment and adverse events and make recommendations on optimal management of patients.Citation
Management of ceritinib therapy and adverse events in patients with ALK-rearranged non-small cell lung cancer. 2017, 111:51-58 Lung CancerJournal
Lung CancerDOI
10.1016/j.lungcan.2017.06.004PubMed ID
28838397Type
ArticleLanguage
enISSN
1872-8332ae974a485f413a2113503eed53cd6c53
10.1016/j.lungcan.2017.06.004