Not a real patient.
Not a real patient.
Non-small cell lung cancer, or NSCLC, is a common form of lung cancer. Metastatic NSCLC (mNSCLC) is when the disease has spread to other parts of the body.
About 5% of people have a change in the anaplastic lymphoma kinase, or ALK, gene. This change in the ALK gene results in an abnormal ALK fusion protein. If this change in the gene is found, then you have ALK+ (ALK positive) NSCLC.
Doctors may test people who have NSCLC to find out if they have ALK+ disease. It’s important to know your ALK status so your doctor can prescribe the appropriate treatment for you.
Once you have confirmed your ALK status, you may have more questions. It may be helpful to discuss these questions with your doctor using the guide below.
You can download, print, and bring this guide with you to your next appointment to get the conversation started. You may also want to bring a notebook with you to help you keep track of past conversations.
Non-small lung cancer, or NSCLC: A cancer that grows from inside your lungs, usually in the cells lining air passages. Not all cancers are classified as non-small cell. This is determined by a biopsy of tumor tissue.
ALK (anaplastic lymphoma kinase): The ALK gene makes an ALK protein, which may be involved in signaling cell growth. Mutations of the ALK gene have been associated with certain types of cancer, including non-small cell lung cancer, sometimes referred to as NSCLC.
Metastatic non-small cell lung cancer (mNSCLC): This means that the cancer has spread. It's also called advanced lung cancer, or stage 4.
Protein: A molecule that is needed for your body to function properly. Proteins, including ALK, are the basis of cells in your body.
Criteria | ALECENSA dose modification |
---|---|
ALT or AST elevation of >5X ULN with total bilirubin ≤2X ULN | Temporarily withhold until recovery to baseline or to ≤3X ULN, then resume at reduced dose. See dose reduction schedule. |
ALT or AST elevation >3X ULN with total bilirubin elevation >2X ULN in the absence of cholestasis or hemolysis | Permanently discontinue ALECENSA. |
Total bilirubin elevation >3X ULN | Temporarily withhold until recovery to baseline or to ≤1.5X ULN, then resume at reduced dose. See dose reduction schedule. |
Any grade treatment-related ILD/pneumonitis | Permanently discontinue ALECENSA. |
Grade 3 renal impairment | Temporarily withhold until serum creatinine recovers to ≤1.5X ULN, then resume at reduced dose. See dose reduction schedule. |
Grade 4 renal impairment | Permanently discontinue ALECENSA. |
Symptomatic bradycardia | Withhold ALECENSA until recovery to asymptomatic bradycardia or to a heart rate of ≥60 bpm. If contributing concomitant medication is identified and discontinued, or its dose is adjusted, resume ALECENSA at previous dose upon recovery to asymptomatic bradycardia or to a heart rate of ≥60 bpm. If no contributing concomitant medication is identified, or if contributing concomitant medications are not discontinued or dose modified, resume ALECENSA at reduced dose upon recovery to asymptomatic bradycardia or to a heart rate of ≥60 bpm. See dose reduction schedule. |
Bradycardiaa (life-threatening consequences, urgent intervention indicated) | Permanently discontinue ALECENSA if no contributing concomitant medication is identified. If contributing concomitant medication is identified and discontinued, or its dose is adjusted, resume ALECENSA at reduced dose upon recovery to asymptomatic bradycardia or to a heart rate of ≥60 bpm, with frequent monitoring as clinically indicated. Permanently discontinue ALECENSA in case of recurrence. See dose reduction schedule. |
CPK elevation of >5X ULN | Temporarily withhold until recovery to baseline or to ≤2.5X ULN, then resume at same dose. |
CPK elevation >10X ULN or second occurrence of CPK elevation of >5X ULN | Temporarily withhold until recovery to baseline or to ≤2.5X ULN, then resume at reduced dose. See dose reduction schedule. |
Hemolytic anemia | Withhold ALECENSA if hemolytic anemia is suspected. Upon resolution, resume at reduced dose or permanently discontinue. See dose reduction schedule. |
aHeart rate <60 bpm.
ALT=alanine transaminase; AST=aspartate transaminase; bpm=beats per minute; CPK=creatine phosphokinase; ILD=interstitial lung disease; ULN=upper limit of normal.
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