Camatinib (Tabrecta) is a targeted MET kinase inhibitor indicated for the treatment of adult patients with metastatic non-small cell lung cancer (NSCLC) harboring MET exon 14 skipping mutations. As a targeted therapeutic agent, camatinib demonstrates excellent efficacy; however, it is accompanied by a series of side effects and medication precautions that require close attention.
What Are the Side Effects of Camatinib (Tabrecta)?
Common Side Effects
Peripheral edema: Occurs in approximately 52% of patients.
Nausea: Incidence of approximately 44%.
Fatigue: Occurs in approximately 32% of patients.
Vomiting: Incidence of 28%.
Dyspnea (shortness of breath): Incidence of 24%.
Decreased appetite: Occurs in approximately 21% of patients.
Serious Side Effects of Camatinib (Tabrecta) That Require Vigilance
Interstitial Lung Disease (ILD)/Pneumonitis
Approximately 4.5% of patients treated with camatinib develop ILD/pneumonitis.
Patients should seek immediate medical attention if they experience new or worsening pulmonary symptoms such as dyspnea, cough, or fever.
Once ILD/pneumonitis is diagnosed and other causes are ruled out, permanent discontinuation of camatinib is required.
Hepatotoxicity
Approximately 13% of patients experience elevations in alanine transaminase (ALT) or aspartate transaminase (AST).
It is recommended to monitor liver function (ALT, AST, and total bilirubin) before treatment initiation and during treatment—every 2 weeks for the first 3 months, then monthly thereafter, or more frequently as clinically indicated.
Depending on the severity of hepatotoxicity, dose interruption, dose reduction, or permanent discontinuation of camatinib may be necessary.
Risk of Photosensitivity Reactions
Animal studies indicate that camatinib may cause photosensitivity reactions.
Although the incidence of photosensitivity reactions was not clearly reported in clinical studies, patients are advised to limit direct exposure to ultraviolet (UV) light during treatment and take sun protection measures such as using sunscreen or wearing protective clothing.
Embryo-Fetal Toxicity
Animal studies have shown that camatinib can cause fetal malformations at doses lower than the clinical exposure levels in humans.
Use in pregnant women may cause fetal harm. Women of reproductive potential should use effective contraception during treatment with camatinib and for 1 week after the last dose.
Female partners of male patients should also use contraception during the same time period.
Precautions for Camatinib (Tabrecta) Use
Patient Selection
Camatinib is only indicated for adult patients with metastatic NSCLC whose tumors have been confirmed to harbor MET exon 14 skipping mutations using a U.S. Food and Drug Administration (FDA)-approved detection method.
The mutation status must be confirmed by molecular testing before initiating treatment.
Drug Interactions
Strong and moderate CYP3A inducers: Concomitant use should be avoided, as they can significantly reduce camatinib plasma concentrations, potentially decreasing its antitumor activity.
Strong CYP3A inhibitors: Close monitoring for adverse reactions is required, as they may increase camatinib exposure.
Drugs that are substrates of CYP1A2, P-glycoprotein (P-gp), or breast cancer resistance protein (BCRP): Camatinib can increase the exposure of these drugs. If concomitant use is necessary, consideration should be given to reducing the dose of these co-administered drugs.
Proton pump inhibitors (PPIs): May reduce camatinib absorption; caution should be exercised when using PPIs concomitantly.
Patient Monitoring and Follow-Up
During treatment, regular monitoring of pulmonary symptoms and liver function is required.
Patients should be educated to recognize the early signs and symptoms of ILD/pneumonitis and hepatotoxicity.
Patients are advised to avoid direct sunlight exposure and take sun protection measures.
Patients of reproductive potential should use effective contraception.
