Dr. Shaw on Monitoring Crizotinib-Related Side Effects

Alice T. Shaw, MD, PhD, an attending physician in the Center for Thoracic Cancers at Massachusetts General Hospital, discusses monitoring adverse events associated with crizotinib when treating patients with ALK-positive lung cancer.

Shaw says that a newly diagnosed patient with ALK-positive lung cancer should take an ALK inhibitor as their first therapy. Crizotinib, an ALK inhibitor, is an easy pill for patients to tolerate and is taken twice a day with food to minimize nausea.

Shaw says she always warns her patients about the onset of visual symptoms, as almost all patients will experience some visual disturbance. These symptoms are mild and are usually triggered by going from a dark environment to a light environment.

Patients’ liver function should also be monitored, Shaw says, as crizotinib carries the risk of transaminitis. Shaw suggests monitoring liver function in patients that are taking crizotinib every two weeks.

Patients on crizotinib can do well for long periods of times- anywhere from 8-10 months to 2-4 years. For patients that remain on crizotinib for long periods of time, Shaw recommends doing surveillance brain MRIs. Even if patients have no history of brain metastases, a proactive approach is recommended, since the risk of developing brain metastases is high, Shaw says.

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