Capmatinib (Tabrecta) is a targeted therapy drug for metastatic non-small cell lung cancer (NSCLC) with MET exon 14 skipping mutation.
How to Use Capmatinib (Tabrecta)
Standard Dosage Regimen
The recommended dose of capmatinib is 400mg orally, twice daily (approximately every 12 hours), which can be taken with food or on an empty stomach.
Administration Method
Patients should swallow capmatinib tablets whole; do not break, crush, or chew them.
This requirement stems from the special formulation process of the drug; destroying the tablet structure may affect the drug's release characteristics and bioavailability.
If a dose is missed or vomiting occurs after administration, the patient should not make up for the missed dose, but take the next dose at the originally scheduled time to avoid an increased risk of adverse reactions due to dose accumulation.
Dosage Adjustment of Capmatinib (Tabrecta)
Dosage Adjustment for Adverse Reactions
When patients experience specific adverse reactions, corresponding measures should be taken according to the severity.
The first dose reduction is to 300mg twice daily, and the second reduction is to 200mg twice daily.
If the patient still cannot tolerate the dose of 200mg twice daily, capmatinib should be permanently discontinued.
Interstitial Lung Disease (ILD)/Pneumonitis
Regardless of the grade, capmatinib should be permanently discontinued once diagnosed.
Such pulmonary complications may be life-threatening and require high vigilance.
In clinical practice, close monitoring should be conducted to check whether patients develop new or worsening pulmonary symptoms, such as dyspnea, cough, or fever. Once ILD/pneumonitis is suspected, the drug should be immediately discontinued and evaluated.
Hepatic Toxicity
For cases of elevated ALT/AST without elevated bilirubin: Grade 3 requires temporary suspension of administration until baseline levels are restored. If recovery occurs within 7 days, the original dose can be continued; otherwise, the dose needs to be reduced.
For Grade 4, permanent discontinuation is required. When elevated ALT/AST is accompanied by elevated bilirubin (without cholestasis or hemolysis), permanent discontinuation should be implemented.
For cases of isolated bilirubin elevation, different measures should be taken according to the severity.
Precautions for Medication in Special Populations of Capmatinib (Tabrecta)
Pregnant Women
Based on animal study data and its mechanism of action, this drug can cause fetal harm.
In animal experiments, pregnant rats and rabbits developed fetal malformations when given capmatinib during the organogenesis period, and the exposure dose causing malformations was lower than that under the human clinical dose.
Female patients of childbearing age should be informed of the potential fetal risks, and effective contraceptive measures should be taken during treatment and within 1 week after discontinuation.
Lactating Women
There is currently no data on whether the drug is excreted in breast milk. However, considering the potential risk of serious adverse reactions to breastfed infants, it is recommended not to breastfeed during treatment and within 1 week after the last dose.
This recommendation is based on the drug's characteristics and known risks of similar molecules, adopting preventive protective measures.
Patients with Renal Impairment
Patients with mild to moderate renal impairment (CLcr 30-89 mL/min) do not require dosage adjustment.
No studies have been conducted in patients with severe renal impairment (CLcr 15-29 mL/min), so special caution should be exercised when using the drug in such patients.
Patients with Hepatic Impairment
Patients with mild, moderate, or severe hepatic impairment (Child-Pugh classification) do not require dosage adjustment, indicating that capmatinib has good tolerability in patients with hepatic impairment.
Close monitoring of liver function is still necessary in clinical practice, especially for patients with pre-existing liver disease.
