Capmatinib (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, while capmatinib demonstrates excellent efficacy, it is also associated with a series of side effects and medication precautions that require vigilance.
What Are the Side Effects of Capmatinib (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: Incidence of 24%.
Decreased appetite: Occurs in approximately 21% of patients.
Serious Side Effects of Capmatinib (Tabrecta) That Require Vigilance
Interstitial Lung Disease (ILD)/Pneumonitis
Approximately 4.5% of patients develop ILD/pneumonitis during capmatinib treatment.
If patients experience new or worsening pulmonary symptoms such as dyspnea, cough, or fever, they should seek medical attention immediately.
Once ILD/pneumonitis is diagnosed and other causes are ruled out, capmatinib must be permanently discontinued.
Hepatotoxicity
Approximately 13% of patients experience elevated ALT/AST levels.
It is recommended to monitor liver function (ALT, AST, and total bilirubin) regularly before and during treatment—every 2 weeks for the first 3 months, then monthly or more frequently based on clinical needs.
Depending on the severity of hepatotoxicity, it may be necessary to suspend medication, reduce the dose, or permanently discontinue treatment.
Risk of Photosensitivity Reaction
Animal studies indicate that capmatinib may cause photosensitivity reactions.
Although the incidence of photosensitivity reactions has not been clearly reported in clinical studies, patients are advised to limit direct ultraviolet (UV) exposure during treatment and take sun protection measures such as using sunscreen or wearing protective clothing.
Embryo-Fetal Toxicity
Animal experiments show that capmatinib can cause fetal malformations at doses lower than the clinical exposure levels in humans.
Use in pregnant women may cause fetal harm. Women of childbearing age should use effective contraceptive measures during treatment and for 1 week after the last dose.
Female partners of male patients should also use contraceptive measures during the same time period.
Precautions for Capmatinib (Tabrecta) Administration
Patient Selection
Capmatinib is only indicated for adult patients with metastatic NSCLC confirmed to have MET exon 14 skipping mutations via FDA-approved testing methods.
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 capmatinib plasma concentrations, potentially weakening its anti-tumor activity.
Strong CYP3A inhibitors: Close monitoring for adverse reactions is required, as they may increase capmatinib exposure.
Drugs that are substrates of CYP1A2, P-gp, or BCRP: Capmatinib can increase the exposure of these drugs; if concomitant use is necessary, consideration should be given to reducing the dose of these drugs.
Proton pump inhibitors: May reduce capmatinib absorption and should be used with caution.
Patient Monitoring and Follow-Up
Pulmonary symptoms and liver function should be monitored regularly during treatment.
Educate patients to recognize the early symptoms of ILD/pneumonitis and hepatotoxicity.
Advise patients to avoid direct sunlight exposure and take sun protection measures.
Patients of childbearing age should use effective contraceptive measures.
