Alecensa (alectinib)

Reviewed by: HU Medical Review Board | Last reviewed: July 2022 | Last updated: July 2022

Alecensa® is a targeted therapy that is used to treat some non-small cell lung cancers (NSCLC) that have a certain anaplastic lymphoma kinase (ALK) mutation. ALK mutation is determined by biomarker tests (molecular testing) conducted on a biopsy sample of the tumor. Alectinib is an ALK inhibitor and is also classified as a tyrosine kinase inhibitor (TKI). It is designed to block the activating sites (tyrosine kinases) of several proteins within the cancer cell. These proteins can stimulate cancer growth when the tumor has an ALK mutation. By blocking the proteins, alectinib may shrink the cancer or slow the cancer’s progression.1-3

Alecensa is used to treat NSCLC with a certain ALK gene mutation that has spread to other parts of the body (metastasized).6

About ALK Mutations

An estimated 3-5% of lung tumors have mutations on the ALK gene, which stands for anaplastic lymphoma kinase. ALK mutations are more common in light smokers (may be defined as less than 10 pack years*) and/or never-smokers (patients may be considered "never smokers" if they have smoked less than 100 cigarettes in their lifetime). These mutations are also associated with younger patient age and adenocarcinomas.4,5

Receiving alectinib

Alectinib is a capsule that is taken by mouth. The dosage of alectinib is determined by several factors, including the patient’s general health and ongoing response to treatment. Patients should take their medication as prescribed by their doctor. Patients should talk to their doctor if they have any questions, or if they have questions regarding their alectinib regimen.1,3

Side effects of alectinib

Alecensa may cause side effects, and in some cases, these side effects can be severe. Any side effects should be reported to a health care professional. Possible side effects experienced by patients taking alectinib may include constipation, diarrhea, headache, weight gain, rash, dizziness, lightheadedness, fainting, and swelling in the hands, feet, ankles or eyelids. Serious side effects that may be caused by alectinib and that require immediate medical care include liver problems, lung problems, kidney problems, slow heartbeat, and muscle pain. Other possible side effects may include fever, vision changes, sudden muscle pain or weakness, back pain, tiredness, rash, itchy skin, loss of appetite, nausea, vomiting, yellowing of the skin or whites of the eyes (jaundice), pain on the right side of the stomach region, dark urine, bleeding or bruising more than normal, and/or new or worsening shortness of breath, difficulty breathing or cough.3

This is not an exhaustive list of all potential side effects of alectinib. Talk to your healthcare provider or pharmacist for further information.

Precautions

If you are pregnant, plan to become pregnant, or are breastfeeding or plan to breastfeed, talk with your doctor. Alectinib can cause harm to a developing fetus and should not be taken by women who are pregnant. While taking alectinib, males with female partners who can become pregnant, and females who can become pregnant, should both use contraceptives during treatment and for a period of time after completing treatment (patients should discuss appropriate birth control methods, and how long they need to use them, with their doctor). Females should not breastfeed during alectinib treatment and for a period of time following the final dose (patients should discuss breastfeeding considerations with their doctor).3*Pack years is a term used to help quantify the equivalent of how many years a patient has smoked.  It is calculated by multiplying the number of packs of cigarettes smoked per day by the number of years the person has smoked. For example, smoking one pack per day for one year equals 1 pack year, whereas smoking two packs per day for two years equals 4 pack years.

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