An ALK-targeted tablet for ALK-positive lung cancer
Alectinib
A targeted tablet used for non-small-cell lung cancer that carries a change in the ALK gene.
What is Alectinib?
Alectinib is a targeted cancer medicine used for a type of non-small-cell lung cancer that is ALK-positive, meaning the cancer is driven by a change in the ALK gene. It works by blocking the faulty ALK protein, which slows or shrinks the cancer. It is taken by mouth, usually twice a day with food, and continued for as long as it helps. It can affect liver blood tests, slow the heart rate, cause muscle aches and raise a muscle blood marker, and make the skin more sensitive to sunlight, so it needs regular monitoring under specialist care.
Education and reference only. This is a plain-language guide to Alectinib — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Alectinib is a targeted cancer treatment known as an ALK inhibitor. It is used for non-small-cell lung cancer that has a particular genetic change making it ALK-positive, which means the cancer cells are driven by an abnormal ALK protein. A test on the tumour confirms this change before the medicine is used. Alectinib is taken by mouth and is given by a cancer specialist team, who decide how long it is used and monitor for side effects. It can also help control disease that has spread to the brain.
How it works
In ALK-positive lung cancer, a change in the ALK gene produces a faulty protein that constantly signals the cancer cells to grow and divide. Alectinib blocks this faulty ALK protein, switching off that growth signal so the cancer slows down or shrinks. Because the cancer keeps making the faulty protein, alectinib is taken every day, continuously, for as long as it keeps the disease under control and is tolerated. It is able to reach the brain well, which is useful when the cancer has spread there.
Company & origin
Originated / developed by: Specialist manufacturer.
A targeted cancer medicine used in the UK for non-small-cell lung cancer that is ALK-positive.
Practical use
How to take Alectinib
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it by mouth as prescribed, usually twice a day with food, at about the same times.
- Swallow the capsules whole with water; do not open or dissolve them.
- Protect your skin from the sun by covering up and using sun protection, as the medicine increases sun sensitivity.
- Report any severe or unexplained muscle pain, weakness, dizziness or a very slow heartbeat.
- Keep taking it every day unless your specialist tells you to pause or stop.
Weighing it up
Advantages & disadvantages of Alectinib
Advantages
- A targeted tablet that can effectively control ALK-positive lung cancer, including disease that has spread to the brain.
- Taken by mouth at home rather than as an infusion.
- Works in a focused way on the faulty protein driving the cancer.
Disadvantages
- Can raise liver blood tests and slow the heart rate.
- Commonly causes muscle aches and can raise a muscle-related blood marker.
- Makes the skin more sensitive to sunlight, and it is not suitable in pregnancy.
Practical use
Good to know
Alectinib is taken with food, which helps the body absorb it properly. A few things are worth watching for: it can raise liver blood tests, so these are checked regularly, and it can slow the heart rate, which may cause dizziness or tiredness. Muscle aches are common, and it can raise a blood marker linked to muscle (creatine kinase), so any severe or unexplained muscle pain or weakness should be reported. It can also make the skin much more sensitive to sunlight, so covering up and using sun protection is important even on cloudy days. As with other targeted cancer medicines of this kind, it can harm a developing baby, so effective contraception is needed during treatment and for a time afterwards. The specialist team reviews how well it is working and manages any side effects, sometimes by adjusting the dose.
Who should not take it / use with caution
- People who have had a serious allergic reaction to alectinib should not take it.
- It must not be used in pregnancy, as it can harm a developing baby, and effective contraception is needed during treatment and for a time after.
- It is used with care, and with monitoring, in people with significant liver problems or a slow heart rate.
- It should only be used under specialist cancer care with regular blood monitoring.
Monitoring
- Regular liver blood tests during treatment.
- Checking the heart rate and watching for symptoms such as dizziness.
- Watching for muscle pain and checking the muscle-related blood marker if symptoms occur.
Side effects
- Muscle aches and tiredness, which are common.
- Changes in liver blood tests and a slow heart rate, which may cause dizziness.
- A rise in a muscle-related blood marker, with severe muscle pain or weakness needing to be reported.
- Increased sensitivity of the skin to sunlight, leading to sunburn more easily.
Key interactions
- Tell your team about all your medicines, as some can affect how alectinib works or add to its effects.
- Care is needed with other medicines that can slow the heart rate.
- Care is needed with other medicines that affect the liver or muscles.
Available as: Capsules taken by mouth.
Answers
Alectinib: frequently asked questions
What is alectinib used for?
It is a targeted medicine for non-small-cell lung cancer that is ALK-positive, meaning the cancer is driven by a change in the ALK gene, confirmed by a test on the tumour.
Why must I take it with food?
Taking it with food helps your body absorb the medicine properly, so it works as intended.
Why should I protect my skin from the sun?
Alectinib can make your skin much more sensitive to sunlight, so covering up and using sun protection helps avoid burning, even on cloudy days.
What should I do about muscle pain?
Some muscle aches are common, but severe or unexplained muscle pain or weakness should be reported, as the medicine can raise a muscle-related blood marker.
Is it safe in pregnancy?
No. It can harm a developing baby, so effective contraception is needed during treatment and for a time afterwards; discuss any plans with your specialist.
Authoritative sources
- BNF
- NICE CKS
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