This leaflet provides information regarding treatment called Lorlatanib. The leaflet will explain what this is and when and how it will be given. It will also tell you about common side effects that you may experience. Contact telephone numbers are given at the end of the leaflet.
What is Lorlatanib?
Lorlatanib is a new cancer treatment which is given as tablets. It is not chemotherapy, but a targeted therapy, which is given for patients with lung cancer with an overproduced protein called ALK.
It is currently unlicensed in the UK, but is licenced in the US. It is awaiting a license in the UK.
Why am I having Lorlatanib?
Lorlatanib has been found to help some patients with your type of cancer, by blocking the ALK protein, which can stop the cancer cells from growing.
How often will I see the specialist team?
You will see the specialist team regularly. You will have regular blood tests and the team will check how you are feeling and discuss any problems you may have. This is so we can check how the treatment is affecting you.
Can I bring relatives and friends with me?
You are welcome to bring someone to stay with you during your treatment. Space is limited so there is not usually room for more than one person. Treatment areas are not suitable for young children.
How should I take the Lorlatanib tablets?
Lorlatanib tablets are usually taken once a day. Try to take them at approximately the same time every day. The tablets should be swallowed whole with a glass of water. They must not be chewed or crushed. The tablets can be taken with or without food.
How many Lorlatanib tablets will I need to take?
The amount you need to take will be clearly marked on the box. Remember to check how many tablets you need to take.
What should I do if I forget to take my tablets?
If you miss a dose, you can take the missed dose as long as it is within 4 hours of the next dose.
What if I take too many tablets?
Please contact Velindre Cancer Centre immediately for advice. The telephone is at the end of the leaflet. Please ask for the treatment helpline.
What if I vomit?
If you vomit after taking your Lorlatanib, do not try to take another dose, wait until your next dose is due.
How should I store the tablets?
Your tablets should be stored in their original packaging and in a safe place away from children. They should be kept in a cool dry place (below 25oC).
Any unused tablets should be returned to the hospital Pharmacy or your local chemist for safe disposal.
What are the possible side effects?
This treatment is usually well tolerated but there are some possible side effects that you need to be aware of. The doctors, nurses and pharmacists can give you advice or answer any questions you may have.
Swelling of ankles and hands:
It is common to develop swelling in your hands, arms, ankles and feet. Inform your doctor in clinic if you experience this. If the swelling is affecting everyday activities phone the treatment helpline: the telephone number is at the end of the leaflet.
Pins and needles or numbness:
You may experience pins and needles or numbness in your finger or toes. Inform your doctor in clinic if you experience this.
Concentration and ability to think or confusion
Lorlatinib can affect your ability to concentrate, it can affect your ability to think and sometimes cause confusion. If you develop confusion or severe problems with concentration or your ability to think clearly, ring the treatment helpline: the telephone number is at the end of the leaflet.
Breathing problems or cough
Some people having Lorlatinib may experience breathing problems caused by the Lorlatanib tablets. If you notice shortness of breath, cough or any breathing problems, please contact your doctor or specialist nurse. You will be monitored at regular clinic visits. If this is severe, ring the treatment helpline; the telephone number is at the end of the leaflet.
Tiredness and fatigue
Lorlatanib can make you feel more tired than usual. It is important to listen to your body and rest if you need to, but carry out your normal activities if you feel able. Some people find it beneficial to take gentle exercise as well as rest.
Muscles and joint pain
Patients may experience muscle and joint pains. Take painkillers to help with this, but if this doesn’t help telephone the treatment helpline; the telephone number is at the end of the leaflet.
Anxiety and depression
Lorlatinib can affect your mood. Patients can experience some anxiety or depression. If you experience this, please let your oncology team know in clinic. If this is severe, however, telephone the treatment helpline; the telephone number is at the end of the leaflet.
Nausea and vomiting
You may experience nausea or vomiting. We will give you anti sickness tablets to take if you need them. However, if you are sick more than once in 24 hours despite taking regular anti-sickness medicine, contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
Effects on your bowels
This treatment has been known to cause either constipation or diarrhoea. Diarrhoea is slightly more common, however.
Skin problems
Some patients may develop a rash. Usually this can be easily treated with some non perfumed cream or lotion. Very rarely this rash can be severe. If it is widespread or itchy, contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
Heart problems
Very rarely some people taking Lorlatanib experience heart problems. You may have a heart tracing, called an ECG before starting the medication; this may be monitored on occasions during your treatment. It is important you inform the doctor if you have a heart condition or you take any heart medication
If you do have any chest pain or feel your heart is beating faster than normal you should seek urgent medical attention.
Blood Clots
A diagnosis of cancer can increase your risk of developing a blood clot (thrombosis), and having cancer treatment may increase this risk further. It is important to tell your doctor immediately if you have symptoms such as pain, redness and swelling in your leg, or breathlessness and chest pain.
Blood clots can be very serious. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information.
Other side effects
Can affect sleeping
Can cause weight gain.
Patients can experience headaches, dizziness and some visual problems. If you experience this, do not drive and inform your oncology team.
Your cholesterol will be monitored during treatment, as this can be affected.
You may be more prone to upper respiratory tract infections and pyrexia, if you develop a cough, produce green phlegm or develop any sign of infection, ring the treatment helpline: the number is at the end of the leaflet.
Rarely, patients have experienced hallucinations or seizures. If you have either of these, ring the treatment helpline, immediately; the telephone number is at the end of the leaflet.
Pregnancy and breastfeeding
Breastfeeding is not recommended during treatment.
Is it alright to take other medicines?
If you are taking other medicines please let your doctor, nurse or pharmacist know as there are some medicines that you may have to avoid. If you are started on any new medication, it is important to inform the doctor you are taking Lorlatinib. Do not take over the counter medication, herbal, vitamin or mineral supplements.
Sometimes cancer drugs can have very serious side effects which rarely can be life threatening. It is important to inform Velindre cancer centre if you are concerned about any side-effects.
Manufacturer’s patient information leaflets
Velindre leaflets provide information about very common and commonly reported side-effects (we are unable to list all of the common side effects), for more information regarding these and the less common side-effects please refer to the manufacturers patient information leaflets, obtained from Velindre pharmacy, or ask for information from the FDA via pharmacy. Sometimes patients may find these leaflets difficult to read however. You can also ask for a copy from your doctor or general practitioner.
Contact telephone numbers
Velindre Cancer Centre 029 2061 5888
For urgent advice at any time of the day or night please ask for the treatment helpline
Pharmacy department 029 2061 5888 ext 6223
Monday – Friday 9am – 5pm for queries about your medicines
Tenovus freephone 0808 808 1010
cancer helpline
Macmillan freephone Helpline 0808 808 0000
This leaflet was written by health professionals. The information contained in this leaflet is evidence based. It has been approved by doctors, nurses and patients. It is reviewed and updated every 2 years.
Prepared February 2019