PMID- 34080177
OWN - NLM
STAT- MEDLINE
DCOM- 20220420
LR  - 20220420
IS  - 1179-1942 (Electronic)
IS  - 0114-5916 (Linking)
VI  - 44
IP  - 8
DP  - 2021 Aug
TI  - Monitoring and Managing Lorlatinib Adverse Events in the Portuguese Clinical 
      Setting: A Position Paper.
PG  - 825-834
LID - 10.1007/s40264-021-01083-x [doi]
AB  - Rearrangements in the anaplastic lymphoma kinase (ALK) and proto-oncogene 
      tyrosine-protein kinase ROS (ROS1) genes characterise two distinct molecular 
      subsets of non-small cell lung cancer (NSCLC) tumours. Lorlatinib is a 
      third-generation ALK/ROS1 tyrosine kinase inhibitor (TKI) shown to have systemic 
      and intracranial activity in treatment-naive patients and in those who progressed 
      on first- and second-generation TKIs. Despite being generally well tolerated, 
      lorlatinib has a unique and challenging safety profile that includes 
      hyperlipidaemia and central and peripheral nervous system adverse events (AEs). 
      This article summarises a set of strategies designed to monitor and manage 
      lorlatinib-related AEs that were agreed upon by a multidisciplinary panel of 
      specialists in a meeting held in July 2020. Among the recommendations hereby 
      described, special emphasis was placed on communication: prescribing physicians 
      should inform patients and their families/caregivers about the likelihood and 
      nature of lorlatinib AEs, encouraging them to report any symptoms, while at the 
      same time reassuring them that most events are manageable and resolve 
      spontaneously and have little to no interference with cancer treatment. 
      Importantly, all patients should undergo a set of baseline assessments, including 
      biochemical analysis, evaluation of cardiovascular risk, electrocardiogram (ECG), 
      neurological evaluation and contrast-enhanced magnetic resonance imaging of the 
      brain, which should be repeated regularly during lorlatinib treatment. Supportive 
      medications to treat or relieve lorlatinib AEs were also discussed, as were the 
      conditions requiring specialist consultations and/or adjustments in lorlatinib 
      therapy. The overall goal of this article is to serve as a practical guide for 
      oncologists to systematically and effectively approach lorlatinib AEs.
CI  - (c) 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
FAU - Barata, Fernando
AU  - Barata F
AD  - Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal. 
      fjssbarata@gmail.com.
FAU - Aguiar, Carlos
AU  - Aguiar C
AD  - Hospital de Santa Cruz, Lisboa, Portugal.
FAU - Marques, Tiago Reis
AU  - Marques TR
AUID- ORCID: 0000-0003-0602-7661
AD  - Psychiatric Imaging Group, MRC London Institute of Medical Sciences (LMS), 
      Imperial College London, London, UK.
AD  - Department of Psychosis Studies, Institute of Psychiatry, Psychology and 
      Neuroscience, King's College London, London, UK.
FAU - Marques, Jose Bravo
AU  - Marques JB
AUID- ORCID: 0000-0001-9848-5832
AD  - Fundacao Champalimaud, Lisboa, Portugal.
FAU - Hespanhol, Venceslau
AU  - Hespanhol V
AUID- ORCID: 0000-0001-6577-0063
AD  - Centro Hospitalar Universitario de Sao Joao, Porto, Portugal.
AD  - Faculdade Medicina do Porto, Porto, Portugal.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210603
PL  - New Zealand
TA  - Drug Saf
JT  - Drug safety
JID - 9002928
RN  - 0 (Aminopyridines)
RN  - 0 (Lactams)
RN  - 0 (Lactams, Macrocyclic)
RN  - 0 (Protein Kinase Inhibitors)
RN  - 0 (Proto-Oncogene Proteins)
RN  - 0 (Pyrazoles)
RN  - EC 2.7.10.1 (Protein-Tyrosine Kinases)
RN  - OSP71S83EU (lorlatinib)
SB  - IM
MH  - Aminopyridines
MH  - *Carcinoma, Non-Small-Cell Lung/drug therapy
MH  - Humans
MH  - Lactams
MH  - Lactams, Macrocyclic/adverse effects
MH  - *Lung Neoplasms/drug therapy
MH  - Portugal
MH  - Protein Kinase Inhibitors/therapeutic use
MH  - Protein-Tyrosine Kinases
MH  - Proto-Oncogene Proteins/genetics/therapeutic use
MH  - Pyrazoles
EDAT- 2021/06/04 06:00
MHDA- 2022/04/21 06:00
CRDT- 2021/06/03 06:53
PHST- 2021/05/18 00:00 [accepted]
PHST- 2021/06/04 06:00 [pubmed]
PHST- 2022/04/21 06:00 [medline]
PHST- 2021/06/03 06:53 [entrez]
AID - 10.1007/s40264-021-01083-x [pii]
AID - 10.1007/s40264-021-01083-x [doi]
PST - ppublish
SO  - Drug Saf. 2021 Aug;44(8):825-834. doi: 10.1007/s40264-021-01083-x. Epub 2021 Jun 
      3.