Alecensa (alectinib) is a medicine used for treating certain lung cancers. Alecensa is used to treat non-small-cell lung cancer (NSCLC) that is anaplastic lymphoma kinase (ALK)-positive. It is used to prevent NSCLC from coming back after surgery to remove the tumor or to treat NSCLC after the cancer spreads to another part of the body.
How Does Alecensa Work for Non-Small-Cell Lung Cancer (NSCLC)?
Alecensa is a type of medicine called a kinase inhibitor. Kinases are enzymes that work in the body by sending and receiving signals that help your cells do important functions like growing and multiplying. Alecensa targets and blocks the action of a certain kinase called anaplastic lymphoma kinase (ALK). Certain lung cancer cells have ALK mutations that allow ALK to send a signal to proteins in the cancer cells that tells the cells to grow and multiply. Alencesa blocks ALK and blocks the signals it sends to help stop cancer cells from growing and multiplying. This makes tumors shrink.
How Do I Take Alecensa?
Alecensa is a capsule that you swallow. You take Alecensa twice a day with food. It is important to take it with food to make sure the medication is absorbed into your body correctly. You should try to take your doses around the same times every day. Alecensa should be taken whole, and you should not open, cut, or dissolve the capsules. If you miss a dose or vomit after taking a dose of Alecensa, skip the dose and do not take the missed dose or an extra dose. Take your next Alecensa dose at the next regular time.
The amount of time you will take Alecensa depends on your specific treatment for NSCLC. If you are taking Alecensa to prevent your NSCLC from coming back after you have had surgery to remove your tumor or tumors, you will take Alecensa for up to 2 years. You may take it for less than 2 years if your cancer progresses or you have side effects that make it not safe for you to continue taking Alecensa. Having your cancer progress can mean your cancer comes back, grows, or spreads. If you are taking Alecensa to treat NSCLC that has spread to other parts of your body (metastatic), you will continue taking Alecensa for as long as possible. This means you will take it until your cancer progresses or you have side effects that make it not safe for you to take. If you have certain side effects when taking Alecensa for any treatment, your health care provider may change or pause your doses of Alecensa. In some cases, they may need to have you stop taking Alecensa completely.
If you have problems with your liver, your dose of Alecensa may be lowered to make sure it is safe for you. Talk with your health care provider about your medical history so they can decide what the best dose of Alecensa is for you.
How Well Does Alecensa Work for NSCLC?
Alecensa was approved by the FDA for ALK-positive NSCLC based on clinical trials that looked at how effective Alecensa was for preventing or treating the cancer.
In the ALINA clinical trial, people took either Alecensa or received chemotherapy to prevent their ALK-positive NSCLC from coming back after you have had surgery to remove your tumor or tumors. The clinical trial included 257 people, with 130 taking Alecensa. They were followed to see how long they stayed alive and did not have their cancer return. After 2 years of starting treatment, 93.8% of the people who took Alecensa were still disease-free and alive compared to 63% of people who received chemotherapy.
In the ALEX clinical trial, people took either Alecensa or another medicine called crizotinib to treat their ALK-positive NSCLC that had spread to other parts of the body and had not been treated since spreading. Crizotinib is another kinase inhibitor that also targets ALK. The clinical trial included 303 people, with 152 taking Alecensa. They were followed to see how long it took for their lung cancer to progress, meaning that the cancer grew or spread. This measurement is called progression-free survival. The median progression-free survival was 25.7 months for Alecensa compared to 10.4 months for the people who took crizotinib. This means that half of the people who took Alecensa did not have their cancer progress for at least 25.7 months compared to 10.4 months for people who took a placebo.
How Will My Progress Be Monitored?
Alecensa will start working as soon as you start taking it. Your health care provider will usually do a scan to see how your cancer is responding to the treatment 6 weeks after you start your medicine. They may choose to do the scan earlier or later than 6 weeks.
Your health care provider will also do regular blood tests to monitor how Alecensa is working in your body. These tests will monitor your blood counts such as red blood cells, white blood cells, neutrophils, and platelets so that your health care provider knows that you can continue to take Alecensa safely. If you have certain side effects such as a cough, your health care provider may do additional tests to make sure it is safe for you to continue to take Alecensa.
How Can I Prevent and Manage Side Effects?
Side effects are common with medicines that treat cancer, including Alecensa. It is important to tell your health care provider about any side effects you have during or after taking Alecensa. They can help to determine if your side effects are serious or provide more information to help you manage the side effects.
Your health care provider will order blood tests regularly for you while you take Alecensa. It’s important to attend all of your appointments for blood tests so that your health care provider can make sure Alecensa is safe for you. These tests will look at your blood cell counts to make sure you do not have any problems with your blood cell counts that make it unsafe for you to take Alecensa. This is because Alecensa can cause low red blood cell counts and cause hemolytic anemia. Hemolytic anemia causes your red blood cells to be broken down quicker than normal. If not treated, hemolytic anemia can cause heart problems that can be dangerous and even life-threatening.
You can ask your health care provider what else you can do to prevent or treat common side effects. For example, you can help to prevent constipation by drinking plenty of fluids. They may also recommend you keep certain over-the-counter medicines on hand to treat common side effects like constipation and what to do if you have severe constipation. They will also tell you how to watch for severe side effects such as lung problems or muscle problems and what to do if you have these side effects.
If you have certain side effects while you take Alecensa, your health care provider may need to change your dose of medicine, pause your doses, or stop your medicine. This will depend on the side effect you experience, how severe it is, and what treatment it needs. If your Alecensa dose needs to be lowered, the medicine will continue to work in your body. If your medicine is paused, your healthcare provider might restart the medication at the same dose or at a lower dose once your side effect is treated and gets better.
What Are Some Other Considerations to Be Aware Of?
Alecensa can cause photosensitivity, which makes your skin more sensitive to light from the sun, sunlamps, and tanning beds. Exposure to this light can cause severe sunburns, blisters, and swelling. If you need to be in sunlight, wear sunscreen, a hat, and clothing that covers your skin while taking Alecensa and for at least 7 days after your last dose. Make sure any sunscreen or lip balm you use has SPF 50 or greater to help prevent sunburn.
Is There Any Cost Assistance Available?
The manufacturer of Alecensa has a program for people who do not have insurance or have financial problems. They also have a program to help provide financial assistance for people with commercial insurance. These programs may be able to offer coupons or savings for Alecensa.
