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NSCLC — SCE Medical Oncology MCQ

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HardLung CancerNSCLCSCE Medical Oncology

Six weeks after starting alectinib, a patient reports severe generalised myalgia and creatine phosphokinase is above five times the upper limit of normal. What is the SmPC-aligned immediate action?

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Correct answer: A — Withhold alectinib, monitor CPK and resume according to recovery and dose-reduction rules

Alectinib can cause clinically important CPK elevation. Severe myalgia with CPK above five times ULN warrants interruption and monitoring, with resumption only after recovery using the SmPC dose-modification rules. Continuing treatment, empiric steroids, an automatic class ban or an immediate unsupervised switch are not the specified first action.

Reference: Alecensa UK SmPC. https://www.medicines.org.uk/emc/product/2438/smpc