A targeted tablet for ALK-positive lung cancer
Brigatinib
A targeted cancer tablet used for advanced non-small-cell lung cancer that has a fault in the ALK gene.
What is Brigatinib?
Brigatinib is a specialist targeted cancer medicine used to treat advanced non-small-cell lung cancer that carries a fault in a gene called ALK. It is taken as a tablet by mouth and works by blocking the faulty signal that drives this cancer to grow. An important and well-known risk, especially in the first week, is sudden lung inflammation that causes new or worsening breathlessness or cough, which must be reported straight away. It can also raise blood pressure, slow the heart, cause visual changes and affect blood tests, so regular monitoring is needed. Like other targeted cancer medicines, it can harm a developing baby, so reliable contraception is essential.
Education and reference only. This is a plain-language guide to Brigatinib — 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
Brigatinib is a targeted cancer medicine, sometimes called an ALK inhibitor, used to treat advanced non-small-cell lung cancer in people whose cancer has a specific gene fault known as ALK-positive. It is taken by mouth as a tablet, usually once a day, under the care of a cancer specialist. Unlike standard chemotherapy, it is aimed at a particular fault that drives this cancer, which is why a test confirming the ALK fault is needed before it is used. It is a long-term treatment that continues for as long as it keeps the cancer under control and is tolerated.
How it works
In ALK-positive lung cancer, a fault in the ALK gene makes a signal that constantly tells the cancer cells to grow and spread. Brigatinib blocks this faulty ALK signal, which slows or stops the cancer growing and can help shrink it. Because it targets the specific driver of this cancer, it tends to work well in people whose tumours carry the ALK fault, including where the cancer has spread to the brain. It is taken every day so the signal stays blocked, and treatment usually continues while it remains effective.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist targeted medicine used in the UK to treat a particular type of advanced lung cancer that has a fault in the ALK gene.
Practical use
How to take Brigatinib
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take the tablet by mouth once a day, at about the same time, swallowed whole with water.
- Follow the planned low starting dose that is increased after the first week, as this lowers the risk of lung problems.
- Report any new or worsening breathlessness, cough or chest tightness straight away, especially in the first week.
- Do not stop or change the dose yourself; your specialist will adjust it based on how you respond and any side effects.
- Use reliable contraception during treatment and for the time afterwards your team advises, as it can harm a baby.
Weighing it up
Advantages & disadvantages of Brigatinib
Advantages
- An effective targeted treatment for ALK-positive lung cancer, including where it has spread to the brain.
- Taken as a once-daily tablet at home rather than as an infusion.
- Aimed at the specific fault driving the cancer, often working when this fault is present.
Disadvantages
- Can cause sudden lung inflammation, particularly in the first week, needing urgent attention.
- Can raise blood pressure, slow the heart and cause visual disturbance, so regular monitoring is needed.
- Can harm a developing baby, so reliable contraception is essential, and it interacts with several other medicines.
Practical use
Good to know
The most important safety point with brigatinib is the risk of sudden lung inflammation (pneumonitis), which can happen in the first days of treatment: any new or worsening breathlessness, cough or chest tightness should be reported urgently, as the dose is usually started low and increased to reduce this risk. It can raise blood pressure and slow the heart rate, so both are checked regularly, and you should tell your team about dizziness, fainting or a very slow pulse. Some people notice visual disturbance, such as blurred vision or seeing flashes, which should be reported. It can also affect blood tests, including muscle and pancreas markers and blood sugar. Because it can harm a developing baby, effective contraception is needed during treatment and for a time afterwards, and it should not be used in pregnancy. Tell your team about all your other medicines, as some interact with brigatinib.
Who should not take it / use with caution
- It must not be used in pregnancy, as it can harm a developing baby.
- People who have had a serious allergic reaction to brigatinib should not take it.
- It is used with caution in people with lung problems, a slow heart rate, high blood pressure or certain liver problems, under specialist supervision.
Monitoring
- Watching for and acting on lung symptoms, especially in the first week of treatment.
- Regular checks of blood pressure and heart rate.
- Blood tests for muscle, pancreas and liver markers and blood sugar, plus eye checks if vision changes.
Side effects
- New or worsening breathlessness, cough or chest tightness from lung inflammation, which needs urgent attention.
- Raised blood pressure, a slow heart rate, or feeling dizzy or faint.
- Visual disturbance such as blurred vision or flashes, nausea, diarrhoea, tiredness or muscle aches.
- Changes in blood tests, including muscle and pancreas markers and blood sugar.
Key interactions
- Some medicines and foods, such as grapefruit, can raise brigatinib levels and increase side effects, so check before using them.
- Other medicines and supplements, such as St John's wort, can lower its levels and make it less effective.
- Medicines that affect blood pressure or heart rate may need reviewing, so give your team a full list of what you take.
Available as: Tablets taken by mouth.
Answers
Brigatinib: frequently asked questions
What is brigatinib used for?
It is a targeted medicine used to treat advanced non-small-cell lung cancer that has a fault in the ALK gene, blocking the faulty signal that drives the cancer.
Why is the dose increased gradually at first?
Starting at a lower dose and increasing it after the first week helps reduce the risk of sudden lung inflammation, which is most likely early in treatment.
What lung symptoms should I report?
Report any new or worsening breathlessness, cough or chest tightness straight away, especially in the first week, as these can signal lung inflammation.
Can I take it if I might become pregnant?
It can harm a developing baby, so you should use reliable contraception during treatment and for the time afterwards your team advises, and it is not used in pregnancy.
Does it affect my heart or blood pressure?
It can raise blood pressure and slow the heart rate, so both are checked regularly; tell your team about dizziness, fainting or a very slow pulse.
Authoritative sources
- BNF
- NICE CKS
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