Monitoring and Managing Lorlatinib Adverse Events in the Portuguese Clinical Setting: A Position Paper.
Journal
Drug safety
ISSN: 1179-1942
Titre abrégé: Drug Saf
Pays: New Zealand
ID NLM: 9002928
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
accepted:
18
05
2021
pubmed:
4
6
2021
medline:
21
4
2022
entrez:
3
6
2021
Statut:
ppublish
Résumé
Rearrangements in the anaplastic lymphoma kinase (ALK) and proto-oncogene tyrosine-protein kinase ROS (ROS1) genes characterise two distinct molecular subsets of non-small cell lung cancer (NSCLC) tumours. Lorlatinib is a third-generation ALK/ROS1 tyrosine kinase inhibitor (TKI) shown to have systemic and intracranial activity in treatment-naive patients and in those who progressed on first- and second-generation TKIs. Despite being generally well tolerated, lorlatinib has a unique and challenging safety profile that includes hyperlipidaemia and central and peripheral nervous system adverse events (AEs). This article summarises a set of strategies designed to monitor and manage lorlatinib-related AEs that were agreed upon by a multidisciplinary panel of specialists in a meeting held in July 2020. Among the recommendations hereby described, special emphasis was placed on communication: prescribing physicians should inform patients and their families/caregivers about the likelihood and nature of lorlatinib AEs, encouraging them to report any symptoms, while at the same time reassuring them that most events are manageable and resolve spontaneously and have little to no interference with cancer treatment. Importantly, all patients should undergo a set of baseline assessments, including biochemical analysis, evaluation of cardiovascular risk, electrocardiogram (ECG), neurological evaluation and contrast-enhanced magnetic resonance imaging of the brain, which should be repeated regularly during lorlatinib treatment. Supportive medications to treat or relieve lorlatinib AEs were also discussed, as were the conditions requiring specialist consultations and/or adjustments in lorlatinib therapy. The overall goal of this article is to serve as a practical guide for oncologists to systematically and effectively approach lorlatinib AEs.
Identifiants
pubmed: 34080177
doi: 10.1007/s40264-021-01083-x
pii: 10.1007/s40264-021-01083-x
doi:
Substances chimiques
Aminopyridines
0
Lactams
0
Lactams, Macrocyclic
0
Protein Kinase Inhibitors
0
Proto-Oncogene Proteins
0
Pyrazoles
0
Protein-Tyrosine Kinases
EC 2.7.10.1
lorlatinib
OSP71S83EU
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
825-834Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
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