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. Alecensa 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, Alecensa 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) and their condition worsened while taking Xalkori (crizotinib), or they were unable to tolerate Xalkori (Xalkori is a drug also used to treat NSCLC).1 In November of 2017, Alecensa was approved by the FDA as a first-line treatment option for NSCLC patients with ALK gene mutation.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

Taking Alecensa

Alecensa 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 Alecensa is determined by several factors, including the patient’s general health and ongoing response to treatment.1,3

Side Effects of Alecensa

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 Alecensa include constipation, diarrhea, headache, weight gain, rash, dizziness, lightheadedness, fainting, and swelling in the hands, feet, ankles or eyelids. Severe side effects that may be caused by Alecensa 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 Alecensa 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 Alecensa, as it may be hazardous to the fetus. It is not recommended for men or women to conceive a child while taking Alecensa, and patients are advised to use barrier methods of contraception (i.e. condoms). It is not known whether Alecensa passes into breast milk, and patients should not breastfeed while taking Alecensa. Patients should avoid unnecessary or prolonged exposure to sunlight while taking Alecensa, 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: October 2018.
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