How to take Crizotinib

Before starting treatment, doctors will choose to treat patients with metastatic non-small cell lung cancer (NSCLC) with Crizotinib based on the presence of ALK or ROS1 positivity in the tumor specimen.

1. Before treatment: Patients should monitor liver function tests every 2 weeks for the first 2 months of treatment, then monthly; monitor complete blood counts during the first month of treatment, then monthly; and more frequently if grade 3 or 4 abnormalities, fever, or infection occur. For pediatric and young adult patients with ALK-positive anaplastic large cell lymphoma (ALCL) or pediatric patients with inflammatory myofibroblastic tumor (IMT), perform baseline and follow-up ophthalmic examinations, including retinal examinations, within 1 month after starting crizotinib and every 3 months thereafter.

2. Management: Crizotinib is available in two forms: oral capsules and granules. Crizotinib capsule preparations can usually be taken with or without food, and the capsules should not be chewed, crushed or split; crizotinib granules can be administered in two ways, such as pouring the contents directly into the patient's mouth, or pouring the contents into the oral administration aids provided (such as spoons, medicine cups). Deliver the pellets directly into the patient's mouth via a dosing aid and administer sufficient water immediately after administration to ensure all medication is swallowed.

3. Recommended dosage:

(1) ALK or ROS1-positive metastatic non-small cell lung cancer: For adult patients, the recommended dose of crizotinib is 250 mg orally twice daily; for patients who are unable to swallow capsules, the recommended dose of granules is 250 mg (2*50mg+1*150mg) orally twice daily until disease progression or unacceptable toxicity occurs.

(2) Relapsed or refractory systemic ALK-positive ALCL: The recommended dose for pediatric patients and young adults is 280 mg/m2 orally twice daily until disease progression or unacceptable toxicity occurs.

(3) Unresectable, recurrent or refractoryALK-positive IMT: The recommended dose for adult patients is 250 mg orally twice daily; the recommended dose for pediatric patients is 280 mg/m2 orally twice daily.

4. Dosage adjustment: If a patient experiences adverse reactions after treatment with crizotinib, the doctor may adjust the drug dose according to the severity of the condition. The first dose will be reduced to 200 mg twice a day; the second dose will be reduced to 250 mg once a day; if you cannot tolerate taking 250 mg once a day, please permanently stop taking crizotinib capsules or granules.

CrizotinibThe original drug has been launched in China and is included in the scope of medical insurance, but it is only reimbursed for patients who meet the indications. The price of each box may be around 15,000 yuan; the price of the Turkish original version of crizotinib sold overseas may be more than more than 10,000 yuan per box (the price may fluctuate due to the exchange rate), which is expensive. There are also cheaper generic crizotinib drugs available overseas. The ingredients are basically similar to those of the original drugs sold domestically and abroad. For example, the price of 250mg*60 tablets produced by a Bangladesh pharmaceutical factory may be more than 2,000 yuan per box (the price may fluctuate due to exchange rates).