Camatinib (Tabrecta) is a targeted therapeutic drug for metastatic non-small cell lung cancer (NSCLC) harboring MET exon 14 skipping mutations.

How to Use Camatinib (Tabrecta)

Standard Dosage Regimen

The recommended dose of camatinib is 400 mg taken orally twice daily (approximately every 12 hours), which can be administered with or without food.

Administration Method

Patients should swallow camatinib tablets whole; do not break, crush, or chew the tablets.

This requirement stems from the drug's special formulation process—damaging the tablet structure may affect the drug's release characteristics and bioavailability.

If a dose is missed or vomiting occurs after administration, the patient should not make up for the missed dose. Instead, the next dose should be taken at the originally scheduled time to avoid an increased risk of adverse reactions due to dose accumulation.

Dose Adjustment of Camatinib (Tabrecta)

Dose Adjustment for Adverse Reactions

When patients experience specific adverse reactions, appropriate measures should be taken based on the severity of the reactions.

For the first dose reduction, adjust to 300 mg twice daily; for the second dose reduction, adjust to 200 mg twice daily.

If the patient still cannot tolerate the dose of 200 mg twice daily, camatinib should be permanently discontinued.

Interstitial Lung Disease (ILD)/Pneumonitis

Regardless of the grade, camatinib should be permanently discontinued once ILD/pneumonitis is diagnosed.

Such pulmonary complications may be life-threatening and require high vigilance.

In clinical practice, close monitoring should be conducted to check whether patients develop new or worsening pulmonary symptoms (such as dyspnea, cough, or fever). Once ILD/pneumonitis is suspected, drug administration should be immediately stopped and an assessment performed.

Hepatic Toxicity

For elevated ALT/AST without elevated bilirubin:

For grade 3 elevation, suspend drug administration until liver function returns to baseline. If recovery occurs within 7 days, treatment can be resumed at the original dose; otherwise, a dose reduction is required.

For grade 4 elevated ALT/AST, permanent discontinuation of the drug is necessary. When elevated ALT/AST is accompanied by elevated bilirubin (without cholestasis or hemolysis), the drug should be permanently discontinued.

For isolated bilirubin elevation, different measures should be taken based on the severity.

Precautions for Camatinib (Tabrecta) Use in Special Populations

Pregnant Women

Based on animal study data and its mechanism of action, this drug can cause fetal harm.

In animal experiments, pregnant rats and rabbits exposed to camatinib during the organogenesis period had fetuses with malformations, and the exposure level at which malformations occurred was lower than the exposure level in humans at the clinical dose.

Female patients of childbearing age should be informed of the potential fetal risks, and effective contraceptive measures should be taken during treatment and for 1 week after drug discontinuation.

Lactating Women

Currently, there is no data on whether the drug is excreted in human milk. However, considering the potential risk of serious adverse reactions to breastfed infants, it is recommended that breastfeeding be avoided during treatment and for 1 week after the last dose.

This recommendation is based on the drug's properties and the known risks of similar molecules, and preventive protective measures are adopted.

Patients with Renal Impairment

Patients with mild to moderate renal impairment (CLcr 30-89 mL/min) do not require dose adjustment.

No studies have been conducted in patients with severe renal impairment (CLcr 15-29 mL/min), so special caution should be exercised when using the drug in such patients.

Patients with Hepatic Impairment

Patients with mild, moderate, or severe hepatic impairment (Child-Pugh classification) do not require dose adjustment, which indicates that camatinib has good tolerability in patients with hepatic impairment.

Close monitoring of liver function is still necessary in clinical practice, especially for patients with a pre-existing liver disease.