Larotrectinib (VITRAVKI)

Solid tumors with NTRK fusion-positive status, advanced or metastatic

Solid tumors with NTRK fusion-positive status, advanced or metastatic

• Oral: 100 mg twice daily continuously until disease progression or unacceptable toxicity

Available as 25 mg and 100 mg hard gelatin capsules or as a 20mg/mL oral solution. Capsules should NOT be opened. Store capsules at room temperature. Solution contains propylene glycol and sodium benzoate. Refrigerate solution and discard 30 days after first opening.

Tropomyosin Receptor Kinase (TRK) Inhibitor

Take with or without 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: Anemia, Neutropenia, Pyrexia, Diarrhea, Constipation, Fatigue, Nausea, Vomiting, ALT increase, AST increase, Hypocalcemia, Musculoskeletal pain, Cough, Myalgia, Dizziness, Hypoalbuminemia.

Less Common: Rash, Edema, Bone fractures, Pneumonia, Sepsis, Cognitive impairment, Headache, Mood disorders, Sleep disorders.

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

Baseline before treatment: CBC & differential, platelets, creatinine, total bilirubin, ALT, alkaline phosphatase, LDH, albumin, calcium, sodium, potassium, phosphorus, random glucose. ALT, total bilirubin, and alkaline phosphatase should be assessed again two weeks after starting treatment.

During treatment: CBC & differential, platelets, total bilirubin, ALT, alkaline phosphatase.

If clinically indicated: calcium, albumin, sodium, potassium, phosphorus, creatinine, LDH, random glucose, INR.

• 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.
• Avoid grapefruit, grapefruit juice, Seville oranges, or Seville orange juice.
• Current drug interaction databases should be consulted for more information.

• Avoid in pregnancy and lactation.
• CNS effects, including cognitive impairment, mood disorders, dizziness, and sleep disturbances have been reported with larotrectinib.

BC Cancer. BC Cancer Drug Manual. Larotrectinib. Vancouver, British Columbia: BC Cancer Agency. Available at: http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Larotrectinib_monograph.pdf. Updated September 1, 2023. Accessed January 22, 2024.

Lexicomp. Larotrectinib Monograph. In: Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc. Available at: https://online.lexi.com/lco/action/doc/retrieve/docid/patch_f/6727995?cesid=7RGLDglePSC&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dlarotrectinib%26t%3Dname%26acs%3Dtrue%26acq%3Dlarotrectinib . Updated January 24, 2024. Accessed January 30, 2024.

Cancer Care Ontario. Larotrectinib Provider Monograph. Drug Formulary. Toronto, Ontario: Cancer Care Ontario. Available at: https://www.cancercareontario.ca/en/drugformulary/regimens/monograph/70326. Updated December 2023. Accessed January 22, 2024.

Bayer Inc. VITRAKVI® Product Monograph. Mississauga, Ontario. Updated January 24, 2022.