How is capmatinib used?

Capmatinib is a targeted drug used to treat a specific type of non-small cell lung cancer (NSCLC). It is a MET inhibitor with good efficacy in lung cancer patients with MET gene mutations, particularly MET exon 14 skipping mutations.

How is capmatinib used?

Patients may experience a range of adverse effects during treatment with capmatinib. In the event of adverse reactions, the drug dose should be adjusted according to the doctor's instructions. According to the drug instructions, the dose adjustment of common adverse reactions is summarized as follows:

1. Dose adjustment

In the event of adverse effects, the dose of capmatinib should be adjusted. Initially, it was recommended to reduce the dose to 300 mg twice daily; If symptoms do not improve, it can be further reduced to 200 mg twice daily. If the patient remains unwell with the 200 mg dose, discontinuation of capmatinib should be considered.

2. Adverse reactions and dose adjustment

Interstitial lung disease (ILD)/pneumonitis

Regardless of the severity of the condition, the drug needs to be stopped immediately.

ALT and/or AST are elevated

Grade 3: Suspend the drug and resume the original dose if liver function returns to normal within 7 days.

Grade 4 or with elevated total bilirubin (without cholestasis or hemolysis): Permanent discontinuation.

Total bilirubin elevated to grade 2 or above: Suspend medication and observe recovery. Depending on the recovery, the decision is made on whether to revert to the original dose, reduce the dose, or permanently discontinue the drug.

What are the drug interactions of capmatinib?

Drug interactions with capmatinib are of particular concern to clinicians and patients. The following are the main drug interactions:

1. CYP1A2 substrate

Concomitant use of capmatinib with CYP1A2 substrates may increase the plasma concentrations of these substrates, causing serious adverse effects. To avoid risks, patients are advised not to use such drugs at the same time. Such substrates include caffeine, aflatoxin B1, and, the commonly used antipyretic analgesic, paracetamol.

2. P-glycoprotein (P-gp) and breast cancer drug resistance protein (BCRP) substrates

When capmatinib is used, if P-glycoprotein and breast cancer resistant protein substrates are taken at the same time, it may lead to obstruction of the excretion of these drugs, increasing the incidence of toxicity or adverse reactions.

It is recommended to avoid concomitant use of these drugs, including the anticancer drugs pazopanib and everolimus, the heart drug digoxin, and the anticoagulants dabigatran etexilate, rivaroxaban, and apixaban.

[Warm tips] The treatment of lung diseases is a long-term process, and patients should maintain a positive and optimistic attitude, actively communicate with the doctor, and follow the doctor's instructions to take the medicine on time and in accordance with the dosage.