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Alunbrig (brigatinib)

How is brigatinib used to treat lung cancer?

Brigatinib is a tyrosine 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 brigatinib is essential, as there is an increased risk of developing certain side effects, such as interstitial lung disease/pneumonitis, hypertension, and abnormally slow heart rate while taking the medication.1 Brigatinib is an orally administered tablet.

How does brigatinib work?

Brigatinib’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, brigatinib works to disable proteins like ALK, ROS1, insulin-like growth factor-1 receptor, and other mutated proteins. Brigatinib also prevents the action of other proteins that depend on the activation of brigatinib-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 brigatinib?

Multiple clinical trials evaluated the safety and efficacy of brigatinib. The most common side effects of brigatinib are:

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

Things to note about brigatinib

Several rare but more serious side effects can accompany brigatinib, 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 brigatinib, and alert your provider immediately if they occur:

  • Fever
  • Cough with or without mucus
  • Chest pain
  • Shortness of breath or trouble breathing

Brigatinib 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). Your 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.

Brigatinib can also cause vision problems. It is important to alert your healthcare 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

Brigatinib 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 brigatinib talk to your healthcare 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
  • Are pregnant or are planning to become pregnant. Brigatinib can harm an unborn baby.
  • Are breastfeeding or planning to breastfeed. It is not known if brigatinib can pass through breast milk.
  • Are taking any other medications, vitamins, or natural supplements

Females should utilize non-hormonal birth control while taking brigatinib 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 brigatinib.

Dosing information

Brigatinib is an oral tablet taken once daily. Your doctor will determine the appropriate dosage for you. Do not change or stop taking your Alunbrig without talking to your provider. 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 brigatinib regimen.

Written by: Casey Hribar | Last reviewed: April 2019.
  1. Alunbrig Prescribing Information. ARIAD Pharmaceuticals, Inc. April 2017. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/208772lbl.pdf