How is Alunbrig used to treat lung cancer?
Alunbrig (brigatinib) is a kinase inhibitor indicated for use by individuals with ALK-positive (anaplastic lymphoma kinase) metastatic non-small cell lung cancer (NSCLC), who are intolerant to or have progressed while on Xalkori (crizotinib). Monitoring of individuals on Alunbrig is essential, as there is an increased risk of developing interstitial lung disease (ILD)/pneumonitis, hypertension, and abnormally slow heart rate while taking the medication.1 Alunbrig is an orally administered tablet with an active ingredient of brigatinib. The brigatinib acts as the kinase inhibitor.
How does Alunbrig work?
Alunbrig’s active ingredient is a tyrosine kinase inhibitor, working specifically to inhibit the phosphorylation of certain proteins in the body. Phosphorylating a protein, or adding a phosphate group, can activate a protein to carry out a specific function. When the function of an active protein is harmful to our body, such as contributing to the development and spread of cancer, it is important to disable or turn it off by preventing its phosphorylation. Specifically, Alunbrig works to disable proteins like ALK, ROS1, insulin-like growth factor 1-receptor, and other mutated proteins. Alunbrig also prevents the action of other proteins that depend on the activation of Alunbrig-targeted proteins, essentially stopping a chain reaction-like process from occurring and contributing to cancer development and spreading.
What are the possible side effects of Alunbrig?
Multiple clinical trials evaluated the safety and efficacy of Alunbrig across many different conditions. The most common side effects of Alunbrig are:
This is not an exhaustive list of all potential side effects of Alunbrig. Talk to your healthcare provider or pharmacist for further information.
Things to note about Alunbrig
Several rare but more serious side effects can accompany Alunbrig, including life-threatening swelling of the lungs. Signs of this are often shown within the first week of treatment, and can be similar to original lung cancer symptoms. It is important to monitor for any changes or worsening in the following symptoms upon starting Alunbrig, and alert your provider immediately if they occur:
- Cough with or without mucus
- Chest pain
- Shortness of breath or trouble breathing
Alunbrig can also increase your risk of developing high blood pressure (hypertension), abnormally slow heart rate (bradycardia), inflammation of the pancreas (pancreatitis), and muscle weakness, pain, or tenderness (myalgia). You doctor will monitor you for any signs of these issues; however, if you notice any signs that these may be occurring, such as dizziness, shortness of breath, feeling faint, upper abdominal pain, or changes in muscle pain or function, alert your provider immediately.
Alunbrig can also cause vision problems. It is important to alert your provider immediately if you notice any of the following symptoms:
- Seeing flashes of light or sensitivity to light
- Blurry vision
- Double vision
- New or increased floaters
Alunbrig can also increase blood sugar levels and lead to hyperglycemia. While your provider should monitor for this as well, it is important to alert them if you notice any of the following:
- Feeling very thirsty or hungry
- Feeling confused, weak or tired
- Feeling sick to your stomach
- Needing to urinate more than usual
Before staring Alunbrig talk to your provider if you:
- Have high blood pressure
- Have a slow heartbeat
- Have lung or breathing problems
- Have a history of pancreatitis
- Have a history of diabetes mellitus or glucose intolerance
- Have lung or breathing problems
- Are pregnant or are planning to become pregnant. It is not known if Alunbrig will affect an unborn baby.
- Are breastfeeding or planning to breastfeed. It is not known if Alunbrig can pass through breast milk.
- Are taking any other medications, vitamins, or natural supplements
Females should utilize non-hormonal birth control while taking Alunbrig and for at least 4 months after stopping treatment. Males should also use effective birth control during treatment and for at least 3 months afterwards. Males should also talk to their provider about the possibility of developing infertility while on Alunbrig.
Alunbrig is an oral tablet taken once daily. Your doctor will determine the appropriate dosage for you, but a typical dosage of Alunbrig is 90 mg for the first 7 days, and then if tolerated, can be increased moving forward. Do not change or stop taking your Alunbrig without talking to your provider. If you miss a dose of Alunbrig or vomit after ingesting Alunbrig, do not take your missed dose. Take your next dose at your normally scheduled time.
- Alunbrig Prescribing Information. ARIAD Pharmaceuticals, Inc. April 2017. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/208772lbl.pdf