Expert Consensus on the Management of Adverse Events of Lorlatinib in the Treatment of ALK+ Advanced Non-small Cell Lung Cancer

Clin Drug Investig. 2024 Aug;44(8):553-576. doi: 10.1007/s40261-024-01379-7. Epub 2024 Jul 31.

Abstract

The use of anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs), such as lorlatinib, for the treatment of patients with ALK gene rearrangement (or ALK-positive) non-small cell lung cancer (NSCLC) has been shown to improve the overall survival and quality of life of these patients. However, lorlatinib is not exempt from potential adverse events. Adequate monitoring and management of these adverse events are critical for increasing patient adherence to lorlatinib, thereby maximizing the benefits of treatment and minimizing the risks associated with treatment discontinuation. Considering that the adverse events of lorlatinib can affect different organs and systems, the participation of a multidisciplinary team, including cardiologists, neurologists, internal medicine specialists, and oncology pharmacists, is needed. This article presents specific and pragmatic strategies for identifying and treating the most relevant adverse events associated with lorlatinib in patients with advanced ALK-positive NSCLC based on the clinical experience of a multidisciplinary panel of experts.

Publication types

  • Review

MeSH terms

  • Aminopyridines* / adverse effects
  • Anaplastic Lymphoma Kinase* / antagonists & inhibitors
  • Anaplastic Lymphoma Kinase* / genetics
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Carcinoma, Non-Small-Cell Lung* / genetics
  • Carcinoma, Non-Small-Cell Lung* / pathology
  • Consensus
  • Humans
  • Lactams*
  • Lactams, Macrocyclic*
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / genetics
  • Lung Neoplasms* / pathology
  • Protein Kinase Inhibitors / adverse effects
  • Protein Kinase Inhibitors / therapeutic use
  • Pyrazoles* / adverse effects
  • Pyrazoles* / therapeutic use

Substances

  • lorlatinib
  • Lactams
  • Anaplastic Lymphoma Kinase
  • Aminopyridines
  • ALK protein, human
  • Pyrazoles
  • Lactams, Macrocyclic
  • Protein Kinase Inhibitors
  • Antineoplastic Agents