Common brand names

• Xalkori

How it is administered

Crizotinib is taken by mouth, available as capsules or oral pellets.

• Adults with ALK- or ROS1-positive metastatic non-small cell lung cancer (NSCLC) or unresectable, recurrent, or refractory ALK-positive inflammatory myofibroblastic tumor (IMT): 250 mg twice daily.
• Pediatric patients and young adults with relapsed or refractory, systemic ALK-positive anaplastic large cell lymphoma (ALCL) or ALK-positive IMT: 280 mg/m² twice daily (dose based on body surface area).

Capsules should be swallowed whole, with or without food. Oral pellets are administered by opening the capsule and pouring the contents directly into the mouth or onto a dosing aid (like a spoon), followed by water. Pellets should not be chewed.

How it works

Crizotinib is a targeted therapy known as a kinase inhibitor. It works by blocking specific proteins in cancer cells, including ALK (anaplastic lymphoma kinase), ROS1, and c-Met. These proteins can become abnormally active in certain cancers, causing the cells to grow and divide uncontrollably.

By inhibiting these proteins, crizotinib helps slow or stop the growth of cancer cells. In blood cancers like ALK-positive anaplastic large cell lymphoma (ALCL) and ALK-positive inflammatory myofibroblastic tumor (IMT), crizotinib targets the abnormal ALK fusion proteins that drive the cancer. This targeted approach can lead to tumor shrinkage and, in some cases, remission.

Crizotinib is also used in some lung cancers with similar genetic changes. Its action is specific to tumors with these genetic alterations, so testing for ALK or ROS1 positivity is required before starting treatment.

Who should take it

Crizotinib is indicated for:

• Pediatric patients (1 year and older) and young adults with relapsed or refractory, systemic ALK-positive anaplastic large cell lymphoma (ALCL).
• Adult and pediatric patients (1 year and older) with unresectable, recurrent, or refractory ALK-positive inflammatory myofibroblastic tumor (IMT).

It is also used in adults with metastatic non-small cell lung cancer (NSCLC) that is ALK- or ROS1-positive.

Patients should have their cancer tested for ALK or ROS1 gene changes before starting crizotinib, as the medication is only effective in cancers with these specific alterations.

Who should not take it

There are no absolute contraindications listed for crizotinib. However, it should be used with caution in certain situations:

• Pregnant women should avoid crizotinib, as it can harm the developing fetus.
• Patients with severe liver or kidney impairment may require dose adjustments.
• People with a history of heart rhythm problems, bradycardia (slow heart rate), or those taking medications that affect heart rhythm should be closely monitored.

Crizotinib should not be used in patients who are allergic to any of its components. Always discuss your full medical history with your healthcare provider before starting crizotinib.

Commonly used with

Crizotinib is usually used as a single agent for ALK-positive ALCL and IMT. In some clinical settings, it may be combined with supportive medications such as antiemetics (to prevent nausea) and antidiarrheal agents, especially in pediatric patients.

It is not typically combined with other chemotherapy agents for blood cancers, but always follow your oncologist's recommendations.

Commonly tested with

Crizotinib has been tested as a single agent in clinical trials for ALK-positive ALCL and IMT. In some pediatric studies, it has been evaluated in combination with chemotherapy, but its safety and effectiveness in combination regimens for newly diagnosed ALCL have not been established.

Routine monitoring includes blood tests (for liver function and blood counts), ECGs (for heart rhythm), and eye exams (for visual side effects).