What are the uses of Pralsetinib (Gavreto)?

Pralsetinib is indicated for the treatment of adults with metastatic non-small cell lung cancer who are RET-fusion positive on FDA-approved testing.

Pralsetinib, also known as Gavreto. This is a kinase inhibitor that works by slowing or stopping the growth of cancer cells. There are many types of kinases, which control different stages of cell development. By blocking a specific enzyme from working, pralsetinib can slow the growth of cancer cells.
Pralsetinib is a type of targeted therapy that blocks a protein called "rearrangement in transmission" (RET). Pralsetinib blocks RET fusion. RET fusion leads to uncontrolled growth of cells and cancer. By inhibiting RET, pralsetinib can slow or stop tumor growth.
Pralsetinib is used to treat certain cancers, such as lung cancer and thyroid cancer.

Pralsetinib is made in tablet form and can be taken directly with or without food. You should take pralsetinib at the same time of day. If you miss a dose by less than 12 hours, you should take the missed dose and then resume your regular dosing schedule. It is important to make sure that you are taking pralsetinib in the correct dose each time.

Pralsetinib blood levels can be affected by certain foods and drugs, so they should be avoided. Foods or medications that interact with pralsetinib include grapefruit, grapefruit juice, Verapamil, Ketoconazole, Rifampin, Phenytoin, and Itraconazole. Depending on the medication you take, a change in the schedule or dosage may be needed. You need to tell your treating doctor or other health professionals about any changes that need to be made.

Store Pralsetinib in its original, labeled packaging at room temperature and in a dry place (unless otherwise directed by your treating physician or other healthcare professional). Keep the medicine container out of the reach of children and pets. Do not flush Pralsetinib tablets or their packaging down the toilet or throw them in the trash.

Decrease in white blood cell count White blood cells play a very important role in fighting infections. While being treated with pralsetinib, your white blood cell count may drop, putting you at higher risk of infection. Warning signs of an infection are a fever over 38 degrees with a sore throat or cold, shortness of breath, cough, burning when urinating, or pain that doesn't heal.
Low red blood cell count (anemia) Red blood cells have an important role in carrying oxygen to the tissues in your body. When your red blood cell count is too low, you may feel tired or weak. You should tell your doctor if you feel short of breath or have chest pain. If your red blood cell count is too low, your doctor may order a blood transfusion.
Decrease in Platelet Count Platelets are important components of blood clotting, so when the platelet count is low, you have a higher risk of bleeding. Watch out for warning signs of a low platelet count, such as any bruising or excessive bleeding, including nosebleeds and bleeding gums. If your platelet count is too low on biochemical tests, you may be given a platelet transfusion.
Kidney problems Pralsetinib can cause kidney problems, including increased levels of Creatinine as shown by blood tests. Tell your doctor if you notice a decrease in urine output, blood in your urine, swelling in your ankles, or loss of appetite.
Peripheral edema Peripheral edema is swelling of the extremities due to fluid retention. Peripheral edema may manifest as swelling of the hands, arms, legs, ankles, and feet. Swollen areas can become uncomfortable.
High blood pressure Pralsetinib can cause high blood pressure. You should actively check your blood pressure regularly during treatment. Any hypertension should be treated appropriately. If your blood pressure is not controlled, your doctor may recommend discontinuing the medication.
Electrolyte abnormalities
Pralsetinib may affect the normal levels of certain electrolytes (e.g. sodium, phosphate, calcium) in your body. Your levels will be monitored with a blood test. If the level of electrolytes in the blood becomes too low, you may need additional intravenous or oral electrolytes. Do not use any supplements without consulting your treating physician first.
Chronic diarrhea The treating doctor may prescribe additional drugs to reduce diarrhea. In addition, you can change your daily diet such as: Eat low-fiber foods; avoiding raw fruits, vegetables, whole grain breads, cereals and seeds; Drink an average of 8 to 10 glasses of non-alcoholic, caffeine-free water each day to prevent possible dehydration.
Other less common side effects:
Lung problems: You are at increased risk of pneumonia or interstitial lung disease that causes scarring of the lungs when using Pralsetinib. Notify your treating doctor immediately if you develop any new or worsening symptoms, including difficulty breathing, shortness of breath, cough, or fever. Bleeding: Pralsetinib can lead to bleeding events, also known as major bleeding. Slow wound healing: Pralsetinib may lead to slower or incomplete healing of wounds, such as non-healing surgical wounds. You should stop taking pralsetinib at least 5 days before any surgery. In addition, pralsetinib should not be started or restarted for at least 2 weeks after major surgery and any surgical incisions should be completely healed. If you have a surgical wound that hasn't healed or is starting to show signs of infection (redness, swelling, heat), tell your doctor. Tumor lysis syndrome: If there was a large amount of tumor cells in your body before treatment, you are at risk for tumor lysis syndrome. This happens when tumor cells die too quickly and their waste overwhelms the body. You may be given Allopurinol and intravenous fluids to help prevent this.

Exposure to pralsetinib to an unborn baby can cause birth defects, so you should not become pregnant or father a child while taking this medicine. Using birth control is necessary during treatment with pralsetinib, even if your menstrual cycle stops or you believe you are no longer producing sperm. You should consult your doctor before breast-feeding while taking pralsetinib. Above are the uses, doses and precautions when using Pralsetinib. To use pralsetinib safely and effectively, patients need to take it exactly as prescribed by their doctor.