brigatinib at a glance
Medicine class
ALK-targeted tyrosine kinase inhibitor
Licensed use
Advanced ALK-positive non-small-cell lung cancer in adults
Before treatment
ALK-positive status must be confirmed using a validated test
Taking the tablets
Swallow whole with water, with or without food
Food warning
Avoid grapefruit and grapefruit juice
What is brigatinib used for?
Licensed uses are:
Alone for adults with ALK-positive advanced non-small-cell lung cancer who have not previously received an ALK inhibitor.
Alone for adults with ALK-positive advanced non-small-cell lung cancer previously treated with crizotinib.
How does brigatinib work?
An abnormal ALK protein can signal cancer cells to grow and divide. Brigatinib blocks ALK tyrosine-kinase activity and downstream signalling, helping to slow cancer-cell growth and spread.
brigatinib preparations and strengths
Tablet
Route: Oral
Strengths: 30 mg, 90 mg, 180 mg
How to take brigatinib
Follow the oncology team's instructions and do not alter or stop treatment without speaking to them.
Swallow tablets whole with water; do not crush or dissolve them.
Take with or without food.
Avoid grapefruit and grapefruit juice because they can increase brigatinib exposure.
If supplied in a bottle, leave the desiccant canister inside and do not swallow it.
brigatinib side effects
Common or expected effects
- Diarrhoea, nausea, vomiting, abdominal discomfort or constipation
- Tiredness, headache or dizziness
- Cough or breathlessness
- Rash, itching or increased sensitivity to sunlight
- Muscle or joint pain
- High blood pressure
- Visual disturbances
- Changes in blood counts, glucose, liver enzymes, pancreatic enzymes, creatine phosphokinase or electrolytes
Get urgent medical advice
- New or worsening breathlessness, cough, chest pain or fever: possible pneumonitis or other serious lung disease
- Fainting, chest discomfort or a markedly altered heartbeat: possible symptomatic bradycardia
- Severe headache, chest pain, breathlessness or visual disturbance associated with high blood pressure
- New or worsening blurred vision, flashes, light sensitivity or reduced vision
- Unexplained muscle pain, tenderness or weakness
- Severe persistent upper-abdominal pain, sometimes spreading to the back: possible pancreatitis
- Yellow skin or eyes, dark urine or right-sided abdominal pain: possible liver injury
- Extreme thirst, frequent urination, weakness or confusion: possible severe hyperglycaemia
brigatinib in pregnancy
Brigatinib may harm a developing baby and should not be used during pregnancy unless the clinical condition requires it. Contact the specialist team if pregnant, planning pregnancy or pregnancy occurs during treatment. Effective non-hormonal contraception is advised for women during treatment and for at least four months afterwards. Men with partners who could become pregnant should use effective contraception during treatment and for at least three months afterwards.
brigatinib while breastfeeding
Breastfeeding should stop during treatment because it is unknown whether brigatinib enters human milk and harm to the baby cannot be excluded. Discuss feeding options with the oncology and maternity teams.
brigatinib interactions
Check prescribed, non-prescribed and herbal products before starting brigatinib. Important examples include:
Strong CYP3A inhibitors, including itraconazole, voriconazole, clarithromycin and ritonavir
These can substantially increase brigatinib exposure and should generally be avoided unless specialist management is arranged.
CYP3A inducers, including rifampicin, carbamazepine, phenytoin and St John’s wort
These can reduce brigatinib exposure and potentially reduce its effectiveness, so concomitant use should be avoided.
Grapefruit and grapefruit juice
These may increase brigatinib concentrations and should be avoided.
Common questions about brigatinib
Answers are fully visible for fast scanning and source review.
Why is an ALK test needed?
Brigatinib targets abnormal ALK signalling, so a validated test is needed to confirm that the cancer is ALK-positive.
Is brigatinib chemotherapy?
It is a targeted tyrosine kinase inhibitor rather than conventional cytotoxic chemotherapy.
Can it be taken with food?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.