Lorlatinib (Lorviqua) is a targeted therapy for the treatment of adult patients with ALK-positive metastatic non-small cell lung cancer (NSCLC). By inhibiting the abnormal activity of ALK kinase, this drug effectively controls tumor growth and metastasis.

Adverse Reactions of Lorlatinib (Lorviqua)

Nervous System-Related Adverse Reactions

(1) Cognitive impairment (28%).(2) Mood changes (21%).(3) Impaired language function (11%).(4) Psychiatric symptoms (7%).(5) Altered mental status (1.3%).

Systemic Adverse Reactions

(1) Edema: Occurring in up to 56% of patients, it mainly presents as swelling of the extremities, face, and periorbital area.(2) Peripheral neuropathy: With an incidence of 44%, common symptoms include numbness and tingling in the hands and feet.(3) Weight gain: Observed in 31% of patients.(4) Fatigue: 27% of patients report significant tiredness.(5) Arthralgia: Joint discomfort occurs in 24% of patients.

Severe Adverse Reactions of Lorlatinib (Lorviqua)

Risk of Hepatic Toxicity

(1) Concurrent use with strong CYP3A inducers may lead to severe liver injury.(2) Prior to lorlatinib administration, strong CYP3A inducers must be discontinued for at least 3 plasma half-lives of the inducer.

Interstitial Lung Disease (ILD)/Pneumonitis

(1) Any grade of treatment-related ILD/pneumonitis requires permanent discontinuation of lorlatinib.(2) The incidence of this severe pulmonary reaction is 1.9%, with 0.6% being grade 3-4.

Hypertension and Blood Glucose Abnormalities

(1) Hypertension: Incidence rate is 13%, with 6% being grade 3-4.

(2) Hyperglycemia: Incidence rate is 9%, with 3.2% being grade 3-4.

Precautions for Lorlatinib (Lorviqua)

Drug Interactions

(1) Strong CYP3A inducers: Concomitant use is contraindicated, as it may cause severe hepatotoxicity.

(2) Strong CYP3A inhibitors: Avoid concurrent use; if co-administration is necessary, dose adjustment of lorlatinib is required.

(3) Moderate CYP3A inducers: Use should be minimized; if unavoidable, the dose of lorlatinib needs to be increased.

Pre-Treatment Examinations

(1) Baseline liver function tests.(2) Electrocardiogram (ECG).(3) Blood lipid level testing.

Regular Monitoring During Treatment

(1) Blood pressure: Monitor 2 weeks after treatment initiation and monthly thereafter.

(2) Blood lipids: Monitor 1-2 months after treatment initiation and on a regular basis.

(3) Electrocardiogram: Periodically monitor cardiac conduction status.