Alectinib (ALECENSARO)

Non-small cell lung cancer ((ALK)-positive), adjuvant

Non-small cell lung cancer ((ALK)-positive), advanced or metastatic

‍Non-small cell lung cancer ((ALK)-positive), adjuvant

• Oral: 600 mg twice daily continuously for 24 months

Non-small cell lung cancer ((ALK)-positive), advanced or metastatic

• Oral: 600 mg twice daily continuously until disease progression or unacceptable toxicity

Available as 150 mg capsules. Capsules contain lactose. Capsules should NOT be opened. Store at room temperature and protect from light.

Anaplastic Lymphoma Kinase(ALK) Inhibitor

Take with food

If a dose is missed, patients should be instructed not to take the missed dose but to resume with the next scheduled dose.

Common: ALT increase, AST Increase, Bilirubin increase, Creatinine phosphokinase increase, Muscular weakness, Myalgia.

Less Common: Atrioventricular block, complete, Bradycardia, Endocarditis, Gastrointestinal perforation, Drug-induced liver injury, Renal insufficiency, Interstitial lung disease/pneumonitis, Photosensitivity reaction, Pulmonary embolism, Vision disorders.

The adverse effects listed above are not exhaustive. Please refer to the relevant product monograph for full details.

Baseline before treatment: alkaline phosphatase, ALT, total bilirubin, LDH, heart rate, blood pressure. ‍

During treatment:  alkaline phosphatase, ALT, total bilirubin and LDH should be monitored every 2 weeks for the first three months of treatment, and at each subsequent visit thereafter  CPK levels should be monitored every 2 weeks for the first month of treatment and as clinically indicated thereafter.

If clinically indicated: calcium, potassium, ECG, heart rate and blood pressure to monitor for cardiotoxicity; creatinine; CPK; chest radiograph for monitoring of dyspnea to rule out development of pneumonitis; chest X-ray and scans to monitor index lesions.

• This drug can impact or be impacted by metabolic enzymes for absorption and excretion. Many drugs can also affect or be affected by these enzymes, so please consult with pharmacy to assess for interactions.
• Current drug interaction databases should be consulted for more information.

• Avoid in pregnancy and lactation.
• Photosensitivity- Patients taking alectinib have a potential for photosensitivity upon sun exposure. Patients should wear protective clothing and/or sunblock during alectinib treatment and for seven days after discontinuation of treatment.
• Ocular disorders have been reported. Patients experiencing vision disorders should be cautious when driving or operating machinery.

BC Cancer. BC Cancer Drug Manual. Alectinib. Vancouver, British Columbia: BC Cancer Agency. Available at : http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Alectinib_monograph.pdf. Updated May 1, 2019. Accessed January 22, 2024.

Lexicomp. Alectinib Monograph. In: Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc. Available at: https://online-lexi-com.qe2a-proxy.mun.ca/lco/action/doc/retrieve/docid/patch_f/5946642?cesid=3FSXDCEqy8e&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dalectinib%26t%3Dname%26acs%3Dfalse%26acq%3Dalectinib. Updated January 24, 2024. Accessed January 28, 2024.

Cancer Care Ontario. Alectinib Monograph. Drug Formulary. Toronto, Ontario: Cancer Care Ontario. Available at: https://www.cancercareontario.ca/en/drugformulary/drugs/monograph/44481. Updated March 2023. Accessed January 22, 2024.Hoffmann-La Roche Limited. ALECENSARO® Product monograph. Mississauga, Ontario. Updated May 11, 2022.