Capmatinib (Tabrecta) is a highly selective MET kinase inhibitor that has become an important targeted therapy for the treatment of metastatic non-small cell lung cancer (NSCLC) harboring MET exon 14 skipping mutations.

Adverse Reactions of Capmatinib (Tabrecta)

Fluid Retention and Systemic Symptoms

Edema: The incidence rate reaches 59%, among which 13% are grade 3–4 severe edema cases, manifesting as peripheral edema, generalized edema, facial edema, etc.

Fatigue: The incidence rate is 34%, with grade 3–4 cases accounting for 8%.

Pyrexia: The incidence rate is 14%.

Gastrointestinal Reactions

Nausea: Occurring in 46% of patients, with 2.4% being grade 3–4 cases.

Vomiting: The incidence rate is 28%, with grade 3–4 cases accounting for 2.4%.

Respiratory Symptoms

Dyspnea: The incidence rate is 25%.

Cough: Occurring in 21% of patients.

Severe Adverse Reactions of Capmatinib (Tabrecta)

Interstitial Lung Disease (ILD)/Pneumonitis

This is one of the most dangerous complications of capmatinib.

Clinical features include new or worsening pulmonary symptoms such as dyspnea, cough, pyrexia, etc.

The management principle emphasizes: immediately suspend medication once ILD/pneumonitis is suspected; permanent discontinuation is required if no other underlying causes are identified after confirmation.

Hepatotoxicity

Elevations in ALT/AST are observed in 15% of patients, with 7% being grade 3–4 cases.

Monitoring requirements include: liver function tests before treatment, every 2 weeks during the first 3 months, and monthly thereafter.

Implement temporary suspension, dose adjustment, or permanent discontinuation based on the severity of the reaction.

Precautions for Capmatinib (Tabrecta)

Standardization of Laboratory Monitoring

Liver function: Monitor ALT, AST and total bilirubin at baseline and regularly during treatment.

Pancreatic function: Monitor amylase and lipase levels.

Other parameters: Including serum creatinine, electrolytes, complete blood count, etc.

Drug Interactions

Strong and moderate CYP3A inducers: Concomitant use must be avoided, as they can significantly reduce the plasma concentration of capmatinib and impair its anti-tumor efficacy.

CYP1A2 substrates: Capmatinib can inhibit CYP1A2, thereby increasing the exposure of co-administered drugs.

P-gp and BCRP substrates: Concomitant use may increase the risk of adverse reactions of these drugs.