In 2017, FDA approved a next generation ALK inhibitor Brigatinib (Brand name ALUNBRIG, Ariad) as a second-line therapy after the treatment from crizotinib (Brand name XALHORI, Pfizer) for ALK+ NSLC (non-small lung cancer). Brigatinib tablets are generally available in 30mg , 90mg and 180mg.
Normally, this medication is well-tolerated by patients, but in around 3% of the patients, there has been reports that patients are experiencing some very rare side effects like shortness of breath within few hours of starting treatment with brigatinib.
Study conducted by researchers from Columbia University and University of Colorado Cancer Centre had offered insights into alternative treatments that would benefit more patients with the help of Brigatinib's side effects.
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Pneumonitis is a rare side effect of anti-cancer therapies, but shortness of breath due to brigatinib's is a unique side effect, according to the study. What's unique about this side effect is that the shortness of breath generally start to occur with first few hours of taking this medication and also this side effect tend to disappear within few days despite continued consumption of Brigatinib.
During the course of the study, researchers had experienced 4 types of outcomes from the start of this side effect. And out of 4, only 3 outcomes yielded in positive results.
• In first case, the patient stops the medication when he starts to experience shortness of breath. After holding on Brigatinib for 7 days, he restarts the medication. He again faced shortness of breath but with supportive care and continued dose of brigatinib was able to recover from shortness of breath on day 5.
• In this case, the patient starts to suffer from shortness of breath within few hours of taking the medication, but the patient continued the medication on the recommended dose along with supportive care, and eventually the patient shortness of breath returned to normal on day 8.
• In third case, the patient was started on high dose of brigatinib 300 mg/day. But when patient started to suffer from shortness of breath, the medication was put on hold for 22 days. After 22 days, the medication was continued but the same side effect occurred again. So, this medication was discontinued for the patient.
• In case 4, patient dosage was reduced to 30 mg/day after experiencing shortness of breath. The dosage was escalated after every 3 days till normal dose required was fulfilled. During this escalating process, no incident was observed.
Our study concludes that with appropriate supportive care along with recommended dose of brigatinib, patients were able to recover from this rare side effect of shortness of breath and can go on continuing with this medication for the treatment of non-small lung cancer.
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Some other Brigatinib side effects are blurred vision, diplopia, cough, visual disturbance, asthenia, dyspnea, hyperglycemia, increased amylase, hypertension, increased creatine phosphokinase in blood specimen, decreased visual acuity, increased serum lipase, and, myalgia. Other side effects may include: pneumonitis, bradycardia, and interstitial pulmonary disease.
The information provided on the page is meant for the purpose of being helpful and educational. It should not be considered as medical advice.
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