Gumetinib is an oral MET inhibitor used for locally advanced or metastatic non-small cell lung cancer with MET14 exon skipping mutations. The standard recommended dose is 300mg once daily, taken on an empty stomach. Fasting should be done at least 2 hours before and 1 hour after taking the medication. The medication should be taken at a fixed time, and the entire tablet should be swallowed without chewing or crushing. The specific dosage adjustment must be determined by the doctor based on adverse reactions and individual tolerance.
1、 Standard dosage and administration method
Recommended dosage: 300mg per dose (6 tablets, 50mg per tablet), taken orally on an empty stomach once a day at a fixed time. one
Swallowing method: Swallow the whole piece, do not chew or crush. If missed once, it can be supplemented if it is more than 12 hours before the next medication, and skipped if it is less than 12 hours. It should be taken normally the next day and cannot be doubled. two
Do not use drugs that affect gastric acid: avoid using them in combination with acid suppressants such as proton pump inhibitors and H2 receptor antagonists. If antacids (such as magnesium aluminum carbonate) must be used, they should be taken at least 2 hours before or after taking this product. three
2、 Dose adjustment principle (under the guidance of a doctor)
Adjustments are usually made in a step-by-step manner based on the severity of adverse reactions.
First reduction: reduced to 250mg per day
Second reduction: reduced to 200mg per day
Third dose reduction: If the patient still cannot tolerate it, the medication will be permanently discontinued
Below is a detailed explanation of the grading of common adverse reactions:
Abnormal liver function (ALT/AST or elevated bilirubin) 1
Level 3 (>5-20 times the normal upper limit): Suspend medication and restore to the original dose or downgrade to restore to ≤ Level 2.
Grade 4 (>20 times the upper limit of normal, or total bilirubin>3 times the upper limit with elevated transaminases): permanent discontinuation of medication.
Non hematological toxicity such as peripheral edema, nausea, vomiting, etc
Level 2 persistent but intolerable: pause, restore to ≤ Level 1, downgrade and resume.
Level 3: Pause, restore to ≤ Level 1, then downgrade and resume; If it is grade 3 and nausea and vomiting cannot be controlled after sufficient supportive treatment, the recovery will be paused and downgraded.
Level 4: Permanent discontinuation of medication.
Interstitial lung disease (ILD)/pneumonia 3
Any level of drug-related ILD/pneumonia must be permanently discontinued and immediately treated according to respiratory protocols.
Other special toxicities (such as QTc interval prolongation, etc.) 4
If the QTc interval is prolonged by more than 500ms or compared to baseline by more than 60ms, the medication should be suspended until it returns to baseline level, and then downgraded and restored; If there is a sharp twisting or polymorphic ventricular tachycardia, the medication will be permanently discontinued.
