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Targeted therapy in cancer treatment is increasingly developing and bringing positive results. Patients with metastatic and ALK-positive non-small cell lung cancer who have failed Crizotinib may receive targeted therapy with the drug Ceritinib. So what is Ceritinib?
1. What is Ceritinib?
Ceritinib is a targeted therapy through tyrosine kinase inhibition. Ceritinib works by blocking certain receptors on cancer cells, thereby blocking or stopping tumor growth. Ceritinib works specifically on tumors that have mutations in the ALK (anaplastic lymphoma kinase) gene. Oncologists will perform tests to check for this mutation before prescribing Ceritinib to patients.
Ceritinib is an approved targeted therapy for metastatic non-small cell lung cancer that has a positive ALK mutation test and is intolerant to Crizotinib.
2. How to use Ceritinib
Ceritinib is available in capsule form for once a day use. However, according to the dosage prescribed by the doctor, the patient may need to take 1 to more Ceritinib tablets at a time. Patients using Ceritinib need to swallow the tablet whole (do not break or chew) on an empty stomach (1 hour before meals or 2 hours after meals). If a dose is missed, the patient should take the dose of Ceritinib as soon as they remember and at least 12 hours before the next dose. If time does not respond, the patient should not take the missed dose of Ceritinib, absolutely do not take 2 doses at the same time to make up.
A very important issue is that the patient must make sure to use the drug Ceritinib exactly according to the dose prescribed by the doctor. Ceritinib blood levels may be affected by certain foods or medications, including grapefruit and grapefruit juice, Ketoconazole, Rifampin, Phenytoin, Warfarin, and Fentanyl. Patients should inform their doctor about a list of all the products they are taking.
Before being treated with Ceritinib, patients should inform their doctor or pharmacist of the following history:
History of allergy to any ingredient in Ceritinib; History of diabetes or high blood sugar and liver disease.
3. Ceritinib side effects
3.1. Vomiting Patients using Ceritinib may experience nausea, vomiting. If this is the case, consult your doctor or nurse about medications to control symptoms. In addition, dietary changes and limiting factors that can make vomiting worse can be helpful. Some measures patients can apply to control vomiting caused by Ceritinib:
Limit overeating at the same time; Limit foods high in fat, fat and spices; Limit acidic foods; Use stomach antacids, salt water, or ginger water to ease symptoms. 3.2. Diarrhea Diarrhea is a potentially serious side effect of Ceritinib due to the risk of dehydration. Patients need to inform their doctor if they have diarrhea while using Ceritinib. Your doctor may prescribe certain medications to control this condition. In addition, the patient can apply some measures such as:
Limit high-fiber foods; Avoid raw fruits, raw vegetables, whole grain breads, cereals and nuts; Use foods with soluble fiber such as apple sauce, ripe bananas, boiled potatoes, chips, products made with white flour or oatmeal; Drink enough water, limit alcohol or caffeine to prevent dehydration. 3.3. Anemia The brand-name drug Ceritinib can lower a patient's red blood cell count and lead to anemia that manifests as fatigue or weakness. Patients should let their doctor know if they experience shortness of breath, rapid breathing, or chest pain during cancer treatment with Ceritinib. Some cases of severe anemia may require additional blood transfusions.
3.3. Decrease in white blood cell count The body's defense against infection relies heavily on white blood cells. During treatment with Ceritinib, a patient's white blood cell count may decrease and lead to an increased risk of infection. Patients should notify their doctor immediately if they develop a high fever, sore throat or cold, difficulty breathing, cough, burning urine, or slow healing of sores.
3.5. Fatigue Fatigue is very common during cancer treatment and is partly due to the drug Ceritinib. During cancer treatment and for some time after treatment ends, patients may need to adjust their daily activity schedule to manage fatigue. Patients need to plan activities, take time to rest and save energy for more important activities.
3.6. Reducing appetite Nutrition is an important part of cancer treatment. However, cancer therapies such as the drug Ceritinib can affect appetite and in some cases make it difficult to eat.
3.7. Constipation There are a number of measures patients can take to prevent or limit constipation caused by Ceritinib . Include more fiber in your diet from fresh fruits and vegetables, drink enough water (limit alcohol) and stay active. In addition, patients can use stool softeners to prevent constipation. If you have not had a bowel movement for 2-3 days, you should contact your doctor for instructions on what to do.
3.7. Liver damage Ceritinib when used carries a risk of hepatotoxicity and requires monitoring with liver function tests. If liver function tests are abnormal, the patient may need to reduce the dose or stop taking Ceritinib. Common manifestations of liver damage include yellowing of the skin or eyes, dark urine or right upper quadrant pain...
3.8. Rash Some patients taking Ceritinib may develop a rash, scaly skin, or itchy bumps. Measures that may help include using an alcohol-free moisturizer, and avoiding those with perfumes or scents. Your doctor may recommend some topical medications if itching is bothersome. If the skin is cracked or bleeding, the patient needs to keep the area clean to avoid bacterial superinfection.
3.9. QT prolongation Ceritinib can lead to a type of arrhythmia called QT prolongation. This condition (rarely) can cause a severe fast or irregular heartbeat and other symptoms (such as dizziness, fainting).
The risk of QT prolongation with Ceritinib may be increased if the patient has certain medical conditions or is taking other drugs that also prolong QT. Before using Ceritinib, patients should tell their doctor about all medications they are taking, history of cardiovascular disease (eg, heart failure, bradycardia, QT prolongation in ECG), family history of QT prolongation ECG or sudden cardiac death.
Low blood potassium or magnesium levels may also increase the risk of QT prolongation, especially common in patients taking certain medications (eg diuretics) or with symptoms such as profuse sweating, diarrhea or vomiting.
Especially, the elderly are susceptible to the QT prolongation side effects of Ceritinib.
3.10. Less common side effects of Ceritinib Pneumonia: Patients can develop pneumonia while taking Ceritinib, so tell your doctor right away if you have symptoms such as cough, shortness of breath or fever; Hyperglycemia: Ceritinib may increase blood sugar in patients with and without a history of diabetes. The treating physician needs to monitor the patient's blood sugar. At the same time, if there are signs of increased thirst, increased urination or feeling hungry, blurred vision, headache or fruity breath, the patient should notify the doctor as soon as possible; Pancreatitis: Ceritinib can cause pancreatitis with symptoms such as increased blood amylase and lipase levels, epigastric pain radiating to the back, and pain worse after eating. Patients should inform their doctor if they develop severe abdominal pain while taking Ceritinib; Increased sensitivity to light: The patient's skin may be more sensitive to the sun, leading to severe sunburn or a rash. Patients should avoid sun exposure between 10 a.m. and 2 p.m., apply sunscreen when out in the sun for long periods of time, and wear sunglasses with UVA/UVB protection. Wear a hat and long clothing for protection, and seek shade whenever possible.
4. Effect on reproductive function of Ceritinib
Ceritinib is not recommended for use during pregnancy because of the risk of harm to the unborn baby. Patients should consult with their doctor about using reliable birth control methods (such as condoms, birth control pills) during treatment with Ceritinib. Also, women of childbearing age should continue to use reliable forms of contraception for at least 6 months after stopping treatment with Ceritinib.
It is not known whether Ceritinib passes into breast milk, however breast-feeding during treatment is still not recommended and continues for at least 2 weeks after stopping the drug. Patients should consult their doctor before breast-feeding if using Ceritinib.
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