Capmatinib (Tabrecta) is a kinase inhibitor targeting metastatic non-small cell lung cancer (NSCLC) with MET exon 14 (METex14) skipping mutations. Its efficacy has been validated in clinical trials; however, during administration, strict adherence to precautions and regular monitoring of relevant indicators are required to optimize therapeutic effects and reduce the risk of adverse reactions.
Precautions for Capmatinib (Tabrecta) Administration
Patient Screening
Capmatinib is only indicated for adult patients with metastatic NSCLC whose tumors have been confirmed to harbor METex14 skipping mutations via an FDA-approved detection method.
Prior to medication administration, molecular testing must be performed to confirm the mutation status, avoiding ineffective treatment.
Drug Interactions
Strong/moderate CYP3A inducers (e.g., rifampicin, efavirenz): May reduce the plasma concentration of capmatinib; concurrent use should be avoided.
Strong CYP3A inhibitors (e.g., itraconazole): May increase capmatinib exposure; close monitoring for adverse reactions is required.
Drugs that are substrates of CYP1A2, P-gp, or BCRP (e.g., caffeine, digoxin, rosuvastatin): Dose adjustments of these co-administered drugs are necessary when used with capmatinib.
Administration Regimen
Recommended Dose: 400 mg orally, twice daily, with or without food.
Missed Dose or Vomiting: Do not make up for the missed dose; take the next scheduled dose at the original planned time.
Dosage Form Handling: Tablets must be swallowed whole; do not break, crush, or chew them.
Management of Common Adverse Reactions
Peripheral Edema (incidence: 52%): Mild cases can be relieved by elevating the affected limbs; dose adjustment is required for severe cases.
Nausea/Vomiting (incidence: 44%/28%): It is recommended to eat small, frequent meals or use antiemetics; temporary drug suspension may be necessary if symptoms persist.
Fatigue (incidence: 32%): Avoid driving or operating machinery; adjust activity intensity appropriately.
Prevention and Control of Special Risks
Interstitial Lung Disease (ILD)/Pneumonitis: Incidence is 4.5%, and cases may be life-threatening. If new or worsening dyspnea, cough, or fever occurs, discontinue the drug immediately and seek medical attention.
Hepatotoxicity: 13% of patients experience elevated ALT/AST. Liver function should be monitored regularly before and during treatment; dose adjustment is required if abnormalities occur.
Photosensitivity Reactions: Animal studies have shown potential phototoxicity. Patients are advised to take sun protection measures (e.g., using sunscreen, wearing protective clothing).
Monitoring for Capmatinib (Tabrecta) Administration
Efficacy Monitoring
Imaging Assessment: Tumor response should be evaluated every 6–8 weeks via CT or MRI, following the RECIST 1.1 criteria to determine therapeutic efficacy.
Symptom Tracking: Monitor changes in tumor-related symptoms such as dyspnea and pain.
Safety Monitoring
Liver Function: Test ALT, AST, and bilirubin before treatment and every 2 weeks during the initial phase of treatment; after 3 months, reduce the frequency to once a month.
Renal Function: Monitor creatinine at baseline and during treatment, especially in patients with moderate renal impairment (creatinine clearance [CLcr]: 30–59 mL/min).
Hematological Indicators: Regularly check lymphocytes, hemoglobin, and other parameters to alert for the risk of infection or anemia.
