Capmatinib (Tabrecta) is a kinase inhibitor targeting metastatic non-small cell lung cancer (NSCLC) with METex14 skipping mutation. Its efficacy has been verified in clinical trials; however, during medication, it is necessary to strictly follow the precautions and conduct regular monitoring of relevant indicators to support therapeutic effects and reduce the risk of adverse reactions.

Precautions for Capmatinib (Tabrecta) Administration

Patient Selection

Capmatinib is only indicated for adult patients with metastatic NSCLC confirmed to have METex14 skipping mutation via FDA-approved detection methods.

Prior to medication, molecular testing is required to confirm the mutation status, so as to avoid 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 necessary.

Drugs that are substrates of CYP1A2, P-gp, or BCRP (e.g., caffeine, digoxin, rosuvastatin): Dosage adjustments of these drugs are required when used concomitantly with capmatinib.

Dosing Regimen

Recommended dose: 400mg orally, twice daily, with or without food.

Missed dose or vomiting: Do not make up for the missed dose; take the next dose at the originally scheduled time.

Dosage form handling: The 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; dosage adjustment is required for severe cases.

Nausea/vomiting (incidence: 44%/28%): It is recommended to take meals in small, frequent portions or use antiemetics; temporary discontinuation of medication may be necessary if needed.

Fatigue (incidence: 32%): Avoid driving or operating machinery; appropriately adjust the intensity of activities.

Special Risk Prevention and Control

Interstitial lung disease (ILD)/pneumonitis: Incidence: 4.5%, which may be life-threatening. If new or worsening dyspnea, cough, or fever occurs, discontinue medication immediately and seek medical attention.

Hepatotoxicity: 13% of patients experience elevated ALT/AST levels. Liver function should be monitored regularly before and during treatment; dosage adjustment is required if abnormalities occur.

Photosensitivity reaction: 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 is evaluated every 6–8 weeks via CT or MRI, and efficacy is determined in accordance with the RECIST 1.1 criteria.

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 treatment period; after 3 months, the frequency can be reduced to once a month.

Renal function: Monitor creatinine at baseline and during treatment, especially in patients with moderate renal impairment (CLcr: 30–59 mL/min).

Hematological indicators: Regularly check lymphocytes, hemoglobin, etc., to be alert to the risks of infection or anemia.