Xalkori (crizotinib)

RATE

Xalkori® 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. Xalkori 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, Xalkori may shrink the cancer or slow the cancer’s progression.1,2

Xalkori is used to treat NSCLC patients with a certain ALK gene mutation that has spread to other parts of the body (metastasized). Xalkori is also used to treat patients with metastatic NSCLC that have an ROS1 mutation.1

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 Xalkori

Xalkori is a capsule taken by mouth, and it can be taken with or without food. Xalkori capsules should be swallowed whole and should not be opened or crushed. The dosage is determined by several factors, including the patient’s general health and ongoing response to treatment.. Patients should not drink grapefruit juice or eat grapefruit during treatment with Xalkori, as it may increase the level of Xalkori in the blood to a harmful level.2

Side Effects of Xalkori

Xalkori 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 in greater than 30% of patients taking Xalkori include vision problems (such as blurred vision, double vision, or increased sensitivity to light), nausea, diarrhea, and vomiting. Less common side effects experienced in 10-29% of patients receiving Xalkori include swelling (edema), constipation, fatigue, decreased appetite, dizziness, increased liver enzymes, numbness or tingling in hands and feet, taste changes, heartburn, and rash. Rarely, Xalkori can cause severe side effects, and patients taking Xalkori should seek medical care immediately if they experience difficulty breathing with a cough or low-grade fever, slow heartbeat, or dizziness. Additional side effects that are not an emergency but require medical attention include frequent diarrhea (4-6 episodes within 24 hours), nausea, vomiting (more than 4-5 times within 24 hours), signs of dehydration (tiredness, dry mouth, dark and decreased urine, or dizziness), eye irritation, yellowing of the skin or whites of the eyes (jaundice), dark or brown urine, decreased appetite, pain on the right side of the stomach region, bleeding or bruising more than normal, itching, or coughing with or without mucus.1,2

Precautions

Patients receiving Xalkori should talk to their doctor about other medications, herbal remedies, and any supplements they are taking. Patients should talk to their doctor before receiving immunizations or vaccinations while taking Xalkori to make sure they are appropriate. Patients who are pregnant or may become pregnant during treatment should discuss their condition with their doctor prior to starting Xalkori, as it may be hazardous to the fetus. It is not recommended for men or women to conceive a child while taking Xalkori, and patients are advised to use barrier methods of contraception (i.e. condoms). It is not known whether Xalkori passes into breast milk, and patients should not breastfeed while taking Xalkori.2

*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.