4 plus years stage 4 NSCLC with ALK mutation

Portal Forums Lung/Thoracic Cancer ALK Inhibitors 4 plus years stage 4 NSCLC with ALK mutation

This topic contains 24 replies, has 6 voices, and was last updated by  lessie 6 months, 2 weeks ago.

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January 29, 2018 at 5:10 pm  #1293902    

beeg2017

Hi Lessie, I remember the pharmacy people told me this. I also included a link to a study proving this recommendation:

https://www.researchgate.net/publication/306384158_Effect_of_Food_and_Esomeprazole_on_the_Pharmacokinetics_of_Alectinib_A_Highly_Selective_ALK_Inhibitor_in_Healthy_Subjects

It certainly is putting the pounds on me and I have to exercise more to keep my weight stable, but am happy to do this if the drug keeps works better and longer.

Hope this helps.
Beeg

January 29, 2018 at 5:34 pm  #1293903    

lessie

Beeg, I am literally stunned that this information was not given to me. If it makes such a significant difference then why are patients not being told to consume the medication with a fat soluble meal? Thankfully your pharmacist told you. I was on alectinib for 2 years and am vegan with low fat diet, and I have had brain mets radiated, with new ones now, plus now progression to mediastinal lymph nodes. Have had a lung nodule in lateral left upper lobe for 4 years that nothing has helped shrink. But just managed. Even had chemo and radiation to the lung in 2016. I can’t help but wonder if I had been taking the medication properly if I would have had better results. So a change in drugs is next for me. Thank you so much for the link.

January 30, 2018 at 10:27 am  #1293909    
catdander forum moderator
catdander forum moderator

I Lessie and Beeg. I’ve asked our oncology pharma doc to comment on this. We should hear from her soon.

January 30, 2018 at 12:01 pm  #1293913    
Dr Walko
Dr Walko

Lessie,

The package insert for alectinib states to take it “with food” in general though a “high fat” meal was shown to increase the exposure of alectinib and it’s active metabolite (that the drug breaks down into) by about 3-fold. So eating a fatty meal prior to alectinib could result in about 3 times higher exposure. This can be variable based on the fat content in each meals and usually dosing is based on just “with food” or “empty stomach” since maintaining specific fat contents for each meal for consistency can be difficult.

Basically, the bottom line is that fatty meals do increase the exposure of alectinib but could also result in higher side effects as well and I would not specifically recommend taking it with a fatty meal unless told so by your doctor. This would need to be considered if dose reductions are needed. The majority of efficacy studies were based on taking with food, not specifically high fat meals so by taking with food in general, you should still be receiving active amounts of the drug and were taking it appropriately.

Reference: Clin Pharmacol Drug Dev. 2017 Jul;6(4):388-397

Best Wishes,
Dr. Walko

  • This reply was modified 6 months, 2 weeks ago by Dr Walko Dr Walko.
  • This reply was modified 6 months, 2 weeks ago by Dr Walko Dr Walko.
January 30, 2018 at 12:39 pm  #1293915    

lessie

Thank you for your prompt reply, Dr. Walco. And thank you for facilitating further information on this matter Janine. I was taking with food per the insert, so that was good. Beeg, wishing you continued success!!

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