What is Lorlatinib: Uses, Dosage, Side Effects and More

Lorlatinib is a targeted cancer medication that blocks specific proteins helping certain lung cancers grow and spread. This prescription drug belongs to a class called ALK inhibitors, which work by interfering with the signals that tell cancer cells to multiply.

If you or someone you care about has been prescribed lorlatinib, it's completely natural to have questions about how it works and what to expect. This medication represents an important advancement in treating specific types of lung cancer, offering hope and improved outcomes for many patients.

What is Lorlatinib?

Lorlatinib is a targeted therapy drug designed to treat non-small cell lung cancer (NSCLC) that has specific genetic changes. It's what doctors call a "precision medicine" because it targets particular proteins found in certain cancer cells.

The medication comes as oral tablets that you take by mouth. Unlike traditional chemotherapy that affects many different cells in your body, lorlatinib specifically targets cancer cells with ALK or ROS1 gene rearrangements. This targeted approach often means fewer side effects compared to broader cancer treatments.

Your doctor will order genetic testing of your tumor tissue to confirm whether lorlatinib is right for your specific type of cancer. This testing helps ensure you receive the most effective treatment for your particular situation.

What is Lorlatinib Used For?

Lorlatinib treats advanced non-small cell lung cancer that has spread to other parts of the body. Specifically, it's used when your cancer cells have changes in genes called ALK (anaplastic lymphoma kinase) or ROS1.

This medication is often prescribed when other ALK inhibitors have stopped working effectively. It's particularly valuable because it can cross the blood-brain barrier, making it effective against cancer that has spread to the brain. Many patients find this especially reassuring since brain metastases can be particularly concerning.

Your oncologist might also recommend lorlatinib as a first-line treatment if you have newly diagnosed ALK-positive lung cancer. The decision depends on various factors including your overall health, the extent of your cancer, and your individual circumstances.

How Does Lorlatinib Work?

Lorlatinib works by blocking specific proteins that cancer cells need to grow and survive. Think of these proteins as switches that tell cancer cells to multiply and spread throughout your body.

When you take lorlatinib, it attaches to these protein switches and turns them off. This action stops the cancer cells from receiving the signals they need to grow and divide. As a result, the cancer cells often die or stop spreading to new areas of your body.

This medication is considered a strong and effective targeted therapy. It's particularly powerful because it can reach cancer cells in the brain, which many other cancer drugs cannot do effectively. This makes it especially valuable for treating lung cancer that has spread to the brain.

How Should I Take Lorlatinib?

Take lorlatinib exactly as your doctor prescribes, usually once daily with or without food. You can take it with a glass of water at any time of day, but try to take it at the same time each day to help you remember.

Swallow the tablets whole without crushing, chewing, or breaking them. If you have trouble swallowing pills, talk to your healthcare team about strategies that might help. They may have suggestions to make taking your medication easier.

You don't need to take lorlatinib with any specific foods, but maintaining good nutrition while on cancer treatment is important. Some people find that taking it with a light snack helps prevent stomach upset, though this isn't required.

Avoid grapefruit and grapefruit juice while taking lorlatinib, as these can increase the amount of medication in your bloodstream. Your doctor will provide you with a complete list of foods and medications to avoid.

How Long Should I Take Lorlatinib For?

You'll typically continue taking lorlatinib for as long as it's working effectively and you're tolerating it well. This could be months or even years, depending on how your cancer responds to treatment.

Your doctor will monitor your progress through regular scans and blood tests. These check-ups help determine whether the medication is controlling your cancer and whether you're experiencing any concerning side effects. Based on these results, your treatment plan may be adjusted.

Never stop taking lorlatinib without discussing it with your oncologist first. Even if you're feeling well, the medication may still be working to control cancer cells you can't feel or see. Your healthcare team will guide you on when and how to safely discontinue treatment if that time comes.

What Are the Side Effects of Lorlatinib?

Like all medications, lorlatinib can cause side effects, though not everyone experiences them. Many people tolerate this medication well, and side effects are often manageable with proper support and monitoring.

Understanding what to expect can help you feel more prepared and confident about your treatment. Let's look at the most common side effects you might experience:

• High cholesterol levels (detected through blood tests)
• Swelling in your hands, feet, or around your eyes
• Weight gain from fluid retention
• Fatigue or feeling more tired than usual
• Changes in mood or thinking, including confusion
• Nerve problems causing tingling or numbness
• Diarrhea or changes in bowel habits
• Nausea or decreased appetite

Most of these side effects are mild to moderate and can be managed effectively. Your healthcare team will monitor you closely and provide strategies to help you feel as comfortable as possible during treatment.

While less common, some people may experience more serious side effects that require immediate medical attention. These rare but important side effects include:

• Severe mood changes, hallucinations, or psychosis
• Severe lung inflammation (pneumonitis)
• Heart rhythm problems
• Severe liver problems
• Eye problems affecting vision
• Severe skin reactions

Contact your healthcare team immediately if you experience any severe or concerning symptoms. They're there to support you and can often provide solutions to help you continue treatment safely.

Who Should Not Take Lorlatinib?

Lorlatinib isn't suitable for everyone, and your doctor will carefully review your medical history before prescribing it. This careful evaluation helps ensure the medication is safe and appropriate for your specific situation.

You should not take lorlatinib if you're allergic to it or any of its ingredients. Your doctor will discuss any known allergies with you before starting treatment. People with certain pre-existing conditions may need special monitoring or alternative treatments.

Several factors may affect whether lorlatinib is right for you:

• Severe liver disease or liver function problems
• Current or recent heart rhythm problems
• Severe kidney disease
• History of severe psychiatric conditions
• Pregnancy or plans to become pregnant
• Breastfeeding or plans to breastfeed

If you're pregnant or could become pregnant, it's crucial to discuss this with your doctor immediately. Lorlatinib can harm an unborn baby, so effective contraception is essential during treatment and for some time after stopping the medication.

Your healthcare team will work with you to determine whether lorlatinib is the best treatment option based on your individual circumstances and medical history.

Lorlatinib Brand Name

Lorlatinib is sold under the brand name Lorbrena. This is the name you'll see on your prescription bottle and medication packaging.

Lorbrena is manufactured by Pfizer and is available only with a prescription from your oncologist. Your pharmacy may use either name when discussing your medication, so it's helpful to know both the generic name (lorlatinib) and brand name (Lorbrena).

When picking up your prescription or discussing your medication with healthcare providers, you can refer to it by either name. Both names refer to the same medication with the same active ingredient.

Lorlatinib Alternatives

Several other ALK inhibitors are available if lorlatinib isn't the right choice for you. Your oncologist will consider various factors when selecting the most appropriate medication for your specific situation.

Alternative ALK inhibitors include alectinib (Alecensa), ceritinib (Zykadia), crizotinib (Xalkori), and brigatinib (Alunbrig). Each of these medications works similarly by blocking ALK proteins, but they have different side effect profiles and effectiveness against different types of ALK mutations.

The choice of ALK inhibitor depends on several factors including whether you've received previous ALK inhibitor treatment, the specific type of ALK mutation you have, and whether your cancer has spread to your brain. Your doctor will discuss these options with you if lorlatinib isn't suitable or stops working effectively.

Is Lorlatinib Better Than Alectinib?

Both lorlatinib and alectinib are effective ALK inhibitors, but they each have unique advantages. The "better" choice depends on your individual circumstances, including your specific type of cancer and treatment history.

Lorlatinib is often more effective against certain ALK mutations that have become resistant to other ALK inhibitors. It's also particularly good at reaching cancer cells in the brain, which makes it valuable for treating brain metastases.

Alectinib, on the other hand, may cause fewer cognitive side effects and is often used as a first-line treatment for newly diagnosed ALK-positive lung cancer. It also has a well-established safety profile and is generally well-tolerated.

Your oncologist will consider factors like your treatment history, the extent of your cancer, and your overall health when deciding between these medications. The goal is to choose the treatment that offers you the best chance of controlling your cancer while maintaining your quality of life.