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Care During Chemotherapy and Beyond

Brigatinib

(bri Ga ti nib)

Trade Name(s): Alunbrig®

Brigatinib is the generic name for the trade name drug Alunbrig. In some cases, health care professionals may use the trade name, Alunbrig, when referring to the generic name, Brigatinib.

Drug Type: Brigatinib is an anti-cancer ("antineoplastic") drug. This medication is classified as an anaplastic lymphoma kinase inhibitor and as a tyrosine kinase inhibitor. (For more detail, see "How Brigatinib Works" below)

What Brigatinib Is Used For

  • Brigatinib is used for the treatment of metastatic anaplastic lymphoma kinase positive non-small cell lung cancer in patients who have progressed on or are intolerant of crizotinib.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe is may be helpful.

How Brigatinib Is Given

  • Brigatinib is a tablet which may be taken with or without food.
  • Swallow tablets whole with at least 8 oz. of water. Do not crush, chew, or dissolve tablets.
  • Avoid grapefruit and grapefruit juice.
  • Take brigatinib at approximately the same time each day.
  • Take brigatinib as prescribed.
  • Do not change your dose or stop brigatinib unless your health care provider tells you to do so.
  • If you miss a dose of brigatinib, it should be taken as soon as possible on the same day with return to the normal schedule the following day. Do not take extra capsules of brigatinib to make up the next dose.
  • Do not take more than 1 dose of brigatinib at one time. Call your health care provider and go to the emergency room right away if you take too much.
  • Store at room temperature (68° F to 77° F); keep medication in original bottle; protect from high humidity, moisture and light.
  • Keep out of reach from children and pets.
  • Safely throw away any brigatinib that is out of date or unused (ask your provider for directions on how to discard the medication).

The amount of Brigatinib that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition you have. Your doctor will determine your exact dosage and schedule.

Side Effects

Important things to remember about the side effects of brigatinib:

  • Most people will not experience all of the side effects listed.
  • Side effects are often predictable in terms of their onset, duration, and severity.
  • Side effects are almost always reversible and almost always go away after therapy is complete.
  • There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
  • Many of the side effects may be quite manageable. There are many options to minimize or prevent the side effects of Brigatinib.

The following side effects are common (occurring in greater than 30%) for patients taking brigatinib:

These are less common side effects (occurring in 10-29%) for patients receiving brigatinib:

Not all side effects are listed above. Side effects that are very rare -- occurring in less than about 10 percent of patients -- are not listed here. But you should always inform your health care provider if you experience any unusual symptoms.

When to Contact Your Doctor or Health Care Provider

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Fever of 100.4° F (38° C) or higher, chills (possible signs of infection)
  • Increased shortness of breath or cough

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • Nausea (interferes with ability to eat and unrelieved with prescribed medication)
  • Vomiting (vomiting more than 4-5 times in a 24-hour period)
  • Diarrhea (4-6 episodes in a 24-hour period)
  • Unusual bleeding or bruising
  • Black or tarry stools, or blood in your stools
  • Blood in the urine
  • Extreme fatigue (unable to carry on self-care activities)
  • Yellowing of the skin or eyes
  • Dark, tea colored urine

Always inform your health care provider if you experience any unusual symptoms.

Precautions

  • Before starting brigatinib treatment, make sure you tell your doctors about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, products containing aspirin unless your doctor specifically permits this.
  • Avoid grapefruit and grapefruit juice.
  • There is potential for drug interaction with many medications including oral contraceptives/hormone medications containing estrogen or progestins, St. John's wort, some antidiabetic medications, some high blood pressure and heart medications.
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking brigatinib.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category X. Brigatinib may cause fetal harm when given to a pregnant woman. This drug must not be given to a pregnant woman or a woman who intends to become pregnant. If a woman becomes pregnant while taking brigatinib, the medication must be stopped immediately and the woman given appropriate counseling).
  • For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking brigatinib. Barrier methods of contraception, such as condoms, are recommended during treatment and for up to 4 months after last dose of brigatinib.
  • Do not breast feed while taking brigatinib.

Self-Care Tips

  • To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
  • Follow regimen of anti-diarrhea medication as prescribed by your health care professional.
  • Eat foods that may help reduce diarrhea (see managing side effects - diarrhea).
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
  • Get plenty of rest.
  • Maintain good nutrition.
  • Remain active as you are able. Gentle exercise is encouraged such as a daily walk.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing While Taking Brigatinib

You will be checked regularly by your doctor while you are taking brigatinib to monitor side effects and check your response to therapy. Periodic blood work will be obtained to monitor your complete blood count (CBC), fasting glucose, CPK level, as well as the function of other organs (such as your liver and pancreas) will be ordered by your provider. Your blood pressure and heart rate will be monitored.

How Brigatinib Works

Brigatinib is not a chemotherapy drug, but one of what are termed "targeted therapies."

Targeted therapy is the result of about 100 years of research dedicated to understanding the different between cancer cells and normal cells. To date, cancer treatment has focused primarily on killing rapidly dividing cells because one feature of cancer cells is that they divide rapidly. Unfortunately, some of our normal cells divide rapidly too, causing multiple side effects.

Targeted therapy is about identifying other features of cancer cells. Scientists look for specific differences in cancer cells and the normal cells. This information is used to create a targeted therapy to attack the cancer cells without damaging the normal cells, thus leading to fewer side effects. Each type of targeted therapy works a little bit differently but all interfere with the ability of the cancer cells to grow, divide, repair and/or communicate with other cells.

There are different type of targeted therapies, defined in three broad categories. Some targeted therapies focus on the internal components and function of the cancer cell. The targeted therapies use small molecules that can get into the cell and disrupt the function of the cells, causing them to die. There are several types of targeted therapy that focus on the inner parts of the cells. Other targeted therapies target receptors that are on the outside of the cell. Therapies that target receptors are also known as monoclonal antibodies. Antiangiogenesis inhibitors target the blood vessels that supply oxygen to the cells, ultimately causing the cells to starve.

More research is needed to identify which cancer may be best treated with targeted therapies and to identify additional targets for more types of cancer.

Brigatinib is a broad spectrum kinase inhibitor with activity against anaplastic lymphoma kinase (ALK) and many other factors. A kinase is an enzyme that helps cells grow and divide. Non-small cell cancer cells with ALK grow and divide faster. By binding to the anaplastic lymphoma kinase and these other factors, brigatinib blocks an important pathway that promotes cell division of these malignant cells.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

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