Food-drug interactions can impact some lung cancer patients
PLYMOUTH MEETING, PA (June 12, 2023) — New research in the June 2023 issue of JNCCN—Journal of the National Comprehensive Cancer Network found that when alectinib—a safe and effective small molecule kinase inhibitor used to treat some types of advanced lung cancer—was taken with a fuller breakfast, or with lunch, it resulted in significantly higher drug concentrations than when it was taken with a lower breakfast. fat. . The researchers, based in Rotterdam, Netherlands, evaluated 20 patients randomly assigned to either take one of two daily doses of alectinib with low-fat yogurt alone, a full continental breakfast, or lunch of their choice. Taking alectinib with low-fat yogurt resulted in 14% less exposure than the continental breakfast group, and 20% less than those who took the drug with lunch.
PLYMOUTH MEETING, PA (June 12, 2023) — New research in the June 2023 issue of JNCCN—Journal of the National Comprehensive Cancer Network found that when alectinib—a safe and effective small molecule kinase inhibitor used to treat some types of advanced lung cancer—was taken with a fuller breakfast, or with lunch, it resulted in significantly higher drug concentrations than when it was taken with a lower breakfast. fat. . The researchers, based in Rotterdam, Netherlands, evaluated 20 patients randomly assigned to either take one of two daily doses of alectinib with low-fat yogurt alone, a full continental breakfast, or lunch of their choice. Taking alectinib with low-fat yogurt resulted in 14% less exposure than the continental breakfast group, and 20% less than those who took the drug with lunch.
“This is important information for patients, because we know that higher blood concentrations of alectinib can result in more drug efficacy, longer treatment duration, and hopefully, better survival,” said the lead researcher. Dan AC Lanser, MSc, Department of Medical Oncology, Erasmus Cancer Institute, Erasmus University Medical Center. “Occasionally, we hear that patients are advised to take alectinib twice a day 12 hours apart, as a result some patients will take it with just a small snack in the morning or evening. We believe that taking it with a large meal containing sufficient fat is far more important for the absorption and efficacy of the medication than waiting 12 hours between doses.”
Relative differences in alectinib plasma concentrations were measured 12 hours after the last dose. The researchers also studied the number and severity of side effects—and found no significant difference between the three groups, which is low overall.
“This important study highlights the key role diet plays in the efficacy of oral cancer drugs,” commented Sandip Patel, MD, Professor in the Department of Medicine at the University of California San Diego School of Medicine and Medical Oncologist at the Moores Cancer Center at UC San Diego Health, who were not involved in this study. “Drug-diet interactions are as important as drug-drug interactions for the treatment of oral cancer.”
Dr. Patel, Member of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®The Panel on Non-Small Cell Lung Cancer, continued: “Alectinib is the standard-care oral small molecule inhibitor for patients with ALK-reregulated metastatic non-small cell lung cancer. Maintaining long-term therapeutic doses is key to the activity of this drug. In this study, the effect of taking a small, low-fat snack dose of alectinib resulted in more than one-third of patients not achieving blood concentrations of the drug alectinib, which highlights the need for education and dietary modification for patients taking this drug long-term.”
To read the entire study, visit JNCCN.org. Free access to “Effect of Foods With Different Fat Concentrations on Alectinib Exposure: A Randomized Crossover Pharmacokinetic Trial” available until September 10, 2023.
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Journal
Journal of the National Comprehensive Cancer Network
DOI
10.6004/jnccn.2023.7017
Research Subjects
People
Article title
Effect of Foods With Different Fat Concentrations on Alectinib Exposure: A Randomized Crossover Pharmacokinetic Trial
Article Publication Date
12-Jun-2023
COI statement
Dr Dumoulin has been disclosed to serve as a consultant for Bristol-Myers Squibb, Roche, AstraZeneca, Pfizer and MSD. Dr. Dingemans said he received honoraria from Eli Lilly, AstraZeneca, Janssen, Chiesi, Pfizer, and Takeda; received grants/research assistance from Amgen; serving as a consultant to Roche; and serves on the data security oversight or monitoring boards for Boehringer Ingelheim, Amgen, Bayer, PharmaMar, and Sanofi. Dr. Mathijssen said he received grants/research support from Roche. Dr Veerman has been disclosed to have received personal expenses from Eli Lilly. The remaining authors have disclosed that they have not received financial consideration from any person or organization to support the preparation, analysis, results, or discussion of this article.
