Consensus recommendations for management and counseling of adverse events associated with lorlatinib: A guide for healthcare practitioners Guidelines
| Authors: | Reed, M.; Rosales, A. L. S.; Chioda, M. D.; Parker, L.; Devgan, G.; Kettle, J. |
| Title: | Consensus recommendations for management and counseling of adverse events associated with lorlatinib: A guide for healthcare practitioners |
| Abstract: | Resistance to first- and second-generation anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) and development and progression of central nervous system metastases remain significant issues in the treatment of ALK-positive non-small-cell lung cancer. Lorlatinib is a novel third-generation ALK TKI that is able to penetrate the blood-brain barrier and has broad-spectrum potency against most known resistance mutations that can develop during treatment with crizotinib and second-generation ALK TKIs. The safety profile of lorlatinib is distinct from those of other ALK TKIs. Adverse events are typically mild to moderate in severity, seldom result in permanent discontinuations, and are generally manageable through lorlatinib dose modifications and/or standard medical therapy. This article provides guidance to advanced practice providers (e.g., nurses, nurse practitioners, physician assistants) and oncology pharmacists for the clinical management of key lorlatinib-emergent adverse reactions (i.e., hyperlipidemias, central nervous system effects, bodyweight increase, edema, and peripheral neuropathy). As lorlatinib is both a substrate and inducer of the CYP3A enzyme system and is contraindicated with strong CYP3A inducers, relevant drug-drug interactions are also highlighted. © 2020, The Author(s). |
| Keywords: | constipation; fatigue; diarrhea; drug safety; hypophosphatemia; side effect; disease association; edema; anemia; nausea; thrombocytopenia; vomiting; myalgia; peripheral neuropathy; body weight; practice guideline; drug effect; central nervous system; arthralgia; backache; coughing; dizziness; dyspnea; fever; hyperglycemia; hypomagnesemia; rash; alanine aminotransferase; alkaline phosphatase; aspartate aminotransferase; hyperkalemia; safety; hypercholesterolemia; speech disorder; visual disorder; non-small cell lung cancer; adverse drug reaction; hyperlipidemia; patient counseling; hypertriglyceridemia; amylase; upper respiratory tract infection; triacylglycerol lipase; central nervous system disease; anaplastic lymphoma kinase; managed care; increased appetite; cytochrome p450 3a; therapy management; body weight disorder; human; article; lorlatinib; advanced practice provider; cytochrome p450 3a inducer |
| Journal Title: | Advances in Therapy |
| Volume: | 37 |
| Issue: | 6 |
| ISSN: | 0741-238X |
| Publisher: | Springer |
| Date Published: | 2020-06-01 |
| Start Page: | 3019 |
| End Page: | 3030 |
| Language: | English |
| DOI: | 10.1007/s12325-020-01365-3 |
| PUBMED: | 32399810 |
| PROVIDER: | scopus |
| PMCID: | PMC7467446 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
