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Alecensa (alectinib)

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 patients 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 (defined as less than 10 pack years*) and/or never-smokers (patients are 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 twice daily. It should be taken with food and should not be crushed or opened before taken. 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. Side effects experienced by patients taking alectinib 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 reported side effects include fever, sudden chest pain, 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

Precautions

Patients receiving alectinib should talk to their doctor about other medications, herbal remedies, and any supplements they are taking. Patients who are pregnant or may become pregnant during treatment should discuss their condition with their doctor prior to starting alectinib, as it may be hazardous to the fetus. It is not recommended for men or women to conceive a child while taking alectinib, and patients are advised to use barrier methods of contraception (i.e. condoms). It is not known whether alectinib passes into breast milk, and patients should not breastfeed while taking alectinib. Patients should avoid unnecessary or prolonged exposure to sunlight while taking alectinib, as the treatment may make the skin more sensitive to sunlight.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.

Written by: Emily Downward | Last reviewed: April 2019.
  1. Alecensa product website, Genentech, Inc. Accessed online on 9/28/16 at https://www.alecensa.com/.
  2. National Cancer Institute. Accessed online on 9/28/16 at https://www.cancer.gov/news-events/cancer-currents-blog/2016/fda-alectinib-nsclc.
  3. MedlinePlus, U.S. National Institutes of Health. Accessed online on 9/28/16 at https://medlineplus.gov/druginfo/meds/a616007.html.
  4. My Cancer Genome. Accessed online on 8/14/16 at https://www.mycancergenome.org/.
  5. Genetics Home Reference, National Institutes of Health. Accessed online on 8/2/16 at https://ghr.nlm.nih.gov/.
  6. Roche Media Release. FDA approves Roche’s Alecensa (alectinib) as first-line treatment for people with specific type of lung cancer. 11/7/17. Accessed online at https://www.roche.com/media/store/releases/med-cor-2017-11-07.htm