135

mg/m^2

iv

over 24hrs followed by cisplatin IV for every three weeks

45

mg

Tablet

Oral

once a day

Continue the treatment until disease progression or unacceptable toxicity occurs  

Dose Adjustments

No adjustment recommended in case of renal and liver impairments

150

mg

Capsule

Oral

twice a day

Continue the therapy until disease progression or unacceptable effects occur 

150

mg

orally

once a day

;before 1 hour or 2 hours after meals
the duration of the therapy continues until disease progression, or unacceptable toxicity occurs
It is used for the patients with metastatic non-small cell lung cancer and for the tumors which have epidermal growth factor receptor exon 19 deletions or exon 21 substitution mutations receiving first-line maintenance or second-line treatment after progression following at least one prior chemotherapy regimen

250

mg

Oral

twice a day

Continue the therapy until disease progression or unacceptable effects occur.

For Monotherapy dosing:

840

mg

Intravenous (IV)

2

weeks

or 1200 mg given IV every three weeks, or 1680 mg given IV every four weeks
Continue the course until disease progression, or unacceptable toxicity occurs
Note:
the first infusion administered for over 60 minutes if well-tolerated, and subsequent infusions administered for over 30 minutes
Combination with platinum-based chemotherapy:
1200 mg given IV every three weeks
Continue the course until disease progression, or unacceptable toxicity occurs
Before chemotherapy, atezolizumab is administered, and bevacizumab is provided on the same day
After completion of 4-6 cycles of chemotherapy, the bevacizumab can be discontinued,
the dosage recommended for atezolizumab is:
840 mg given IV every two weeks or 1200 mg given IV every three weeks, or 1680 mg given IV every four weeks
Continue the course until disease progression, or unacceptable toxicity occurs
Note:
the first infusion administered for over 60 minutes if well-tolerated, and subsequent infusions administered for over 30 minutes

450

mg

Capsule

Oral

once a day

Continue the therapy until disease progression or unacceptable toxicity occurs 

Dose Adjustments

Renal impairment:  Mild/moderate renal impairment (CrCl 30 < 90 ml/min):   No adjustment recommended.  Severe renal impairment (CrCl <30 ml/min):   Data not available  Liver impairment:  Mild (Child-Pugh A/B):   No adjustment recommended.  Severe (Child-Pugh C):   Reduce dose to one third and round to the nearest multiple of the 150 mg dose strength

2

mg

Oral

once a day

in combination with dabrafenib

600

mg

Capsule

Orally 

once a day

90

mg

Tablet

Orally 

once a day

Maintenance dose is 180 mg orally once a day 

Dose Adjustments

Hepatic impairment:  Mild/moderate (Child-Pugh A/B):   No dose adjustment required  Severe (Child-Pugh C):   Reduce one daily dose by 40% (like, from 180mg 120 mg, 120 mg to 90 mg)  Renal impairment:  Mild/moderate (CrCl 30-89 ml/min):   No dose adjustment required  Severe (CrCl 15-29 mL/min):   Reduce dose by 50% (like, from 180 mg to 90 mg) 

360

mg

Solution

Intravenous (IV)

every 3 weeks

Indicated for NSCLC, metastatic non-small cell lung cancer in those patients who have tumors of anaplastic lymphoma kinase (ALK)-positive
100 mg orally each day with/without food Continue until unacceptable toxicity or disease

Dose Adjustments

In case of adverse reactions:
1st dose reduction: 75 mg each day
2nd dose reduction: 50 mg each day
If unable to tolerate the dose of 50 mg per day: permanently discontinue the medication

In case of effects on central nervous system:
1st grade: Continue the same dose until recovery to baseline; start over at the same or decreased dose
2nd or 3rd grade: Pause the dose until less than first grade; start over at reduced dose
4th grade: permanently discontinue the medication

Indicated for non-small lung cancer in combination with cisplatin
1000 mg/m² intravenously for 30 minutes on 1st, 8th and 15th day of 28-day cycle
1250 mg/m² intravenously for 30 minutes on 1st and 8th day of a 21-days cycle
Administer 100 mg/m² cisplatin intravenously after giving gemcitabine on day 1

gefitinib is used to treat adult patients with NSCLC metastatic non-small cell lung cancer 250 mg four times daily until the disease is reduced or unacceptable toxicity is achieved

Dose Adjustments

Permanently discontinue the medication in case of:
Severe hepatic impairment
Persistent ulcers
Gastrointestinal perforation
Interstitial lung disease
When co-administering the drug with CYP3A4 inducers, increase the dose to 500 mg orally daily
Restart the dose of 250 mg per day after the discontinuation of CYP3A4 inducer

Adjuvant therapy
80 mg tablet orally once daily
Continue for up to three years, or until disease recurrence or unacceptable toxicity

Note:
Adjuvant treatment recommended after tumour resection for non-small cell lung cancer with EGFR exon 19 del mutation or 21 L858R mutation

First-line treatment for metastatic NSCLC
80 mg tablet orally once daily; until disease recurrence or unacceptable toxicity occurs

Note:
First-line therapy recommended for patients with metastatic NSCLC who have EGFR exon 19 del mutation or 21 L858R mutation

Previously treated metastatic NSCLC
80 mg tablet orally once daily; until disease recurrence or unacceptable toxicity occurs

Note:
Referred to as a treatment for metastatic NSCLC with the EGFR T790M mutation that has progressed during or after EGFR TKI treatment

Indicated for metastatic (HER-2 mutant) cancer in patients who have taken a prior chemotherapy
5.4 mg/kg intravenously every 3 weeks as a 21-day cycle
Continue until the disease is progressed

400

mg

Orally 

every day

Continue until the illness progresses or intolerable toxicity occurs

600

mg

Orally

twice a day

Continue until the illness progresses or intolerable toxicity occurs.

960mg orally every day

Dose Adjustments

Dosage Modifications
Levels of dosage reduction for adverse reactions
First dosage reduction: 480 mg every day
Second dosage reduction: 240 mg every day
If 240 mg every day is intolerable, discontinue treatment.

Hepatotoxicity
Refrain from use until AST/ALT returns to Grade 1 or baseline if symptoms are present with a Grade 2 reading. Grades 3 through 4 for AST/ALT
Continue at the next lower dosage level. Without other reasons, permanently cease AST/ALT >3x ULN with total bilirubin [TB] >2x ULN.
Pneumonitis (of any grade)/interstitial lung disease (ILD)
ILD/pneumonitis suspect: Withhold
ILD/pneumonitis confirmed: Discontinue indefinitely

Vomiting or Nausea
This occurs despite supportive treatment (for example, antiemetic therapy).
3rd or 4th Grade: Withhold until recovery to Grade ≤1 or baseline is achieved, then continue at the next lower dosage level.

Diarrhea
Grades 3 or 4: Refuse until Grade ≤1 or baseline recovery; continue at the subsequent lower dosage level.

Combined use of acid-reducing medications
Avoid simultaneously using antacids, H2-receptor antagonists, and proton pump inhibitors (PPIs).
Take sotorasib four hours before or ten hours after giving antacids if usage is necessary and cannot be avoided.

Hepatic impairment
Child-Pugh A or B: Mild-to-moderate: No dose change is required
Hepatotoxicity is a potential danger for patients with severe hepatic impairment; the effect is unclear, thus they should be monitored more closely.

Renal impairment
No dose change is required for mild-to-moderate (eGFR≥30 mL/min/1.73 m2) conditions.
Unstudied for severe (eGFR<30 mL/min/1.73 m2)

450 mg orally on a daily basis is recommended
The duration of treatment should continue until the progress

Indicated for Non-Small Cell Lung Cancer
Pending FDA approval for treatment of metastatic EGFR T790M-mutant NSCLC (Non-Small Cell Lung Cancer)

First-line chemotherapy with pemetrexed and platinum for nonsquamous small cell lung cancer (NSCLC) is awaiting FDA approval.

Dose according to body weight
For individuals Weight less than 80 kg-
For (Week first, Day first)- single dose of 350 mg intravenously
For (Week first, Day second- single dose of 700 mg Intravenously
For (Weeks second-fourth)- 1050 mg Intravenously once a week
For (Week fifth and onwards)- 1050 mg Intravenously every two weeks
Maintain this course of Treatment until signs of progression appear
For individuals 80 kg or more
For (Week first, Day first)- one dose of 350 mg intravenously
For (Week first, Day second)- one dose of 1050 mg intravenously
For (Week second-fourth)- 1400 mg intravenously once in a week
For(Week 5 and onwards)- dose of 1400 mg intravenously every two weeks
Maintain this course of Treatment until signs of progression appear

Administer 400mg orally twice a day

Dose Adjustments

Dose adjustments for adverse effects
Restart at 300mg orally twice a day for the first occurrence.
Restart at 200mg orally twice a day for the first occurrence.
Inability to take 200 mg orally twice a day: Permanently stop using

Administer dose of 80 to 100 mg/m2 intravenously

Non-Small Cell Lung Cancer Metastatic
Administer 40 mg orally daily until the patient can no longer take it or the condition progresses.

Squamous Non-Small Cell Lung Cancer Metastatic
Administer 40 mg orally daily until the patient can no longer take it or the condition progresses.

Dose Adjustments

Dosage modification
Withhold dose in the event of adverse drug reactions
Cancer Institute's Adverse Events Common Terminology Criteria (NCI CTCAE) Grade ≥3
Prolonged (more than 7 days), Grade 2 cutaneous responses or unendurable
Grade≥2 Renal Impairment
Grade 2 diarrhea that lasts for two or more days when being treated with anti-diarrhea medicine

Restart therapy after the adverse response is entirely resolved, returns to normal, or gets better to Grade 1


Discontinue permanently
Exfoliative, exudative, or bullous skin lesions that are potentially fatal.
ILD (Interstitial Lung Disease) Diagnosis Confirmed
Severe hepatic impairment due to drug use.
Keratitis ulcerata persistens
Dysfunction of the left ventricle, causing symptoms.

Renal impairment
Moderate to mild (CrCl 30-89 mL/min/1.73 m²): No dosage adjustment is necessary.
Severe (CrCl 15-29 mL/min/1.73 m²): Administer 30mg orally every day
Severe (CrCl 15-29 mL/min/1.73 m²): Not investigated.

On Days 1, 8, and 15 of each 21 days, 100 mg/m2 was intravenously administered over 30 minutes, along with

On Day 1 of each 21-day cycle, directly following the injection of paclitaxel protein, carboplatin AUC of 6 mg/min/mL intravenously is administered.

KRAS G12C-mutant driven non-small cell lung cancer (NSCLC) (off-label)
With parenteral minimal effective dosages of 1 mg per kg, 3 mg per kg, 10 mg per kg, and 2 mg per kg, respectively, this medication showed strong anti-tumor action in human lung adenocarcinoma, multiple KRAS G12C-mutant tumor models, colonic adenocarcinoma, and lung cancer models in a phase I trial. :

Dose Adjustments

Limited data is available

Non small cell lung cancer (NSCLC, ROS1 positive) (off-label)
According to study presented at the 2022 European Lung Cancer Congress, unecritinib may increase frontline treatment choices for patients with NSCLC (locally progressed or metastatic non-small-cell lung cancer) that is ROS1-positive
The dose which is studied in phase 2 was 100 mg, 200 mg, and 300 mg via oral administration four times per day for four weeks, and the:

Dose Adjustments

Limited data is available

NSCLC (non-small cell lung cancer) (off-label)
According to one study, it can dramatically slow the growth of lung cancer cells that are not small cell
This was also able to modulate the RAD5 expression, a gene that is commonly seen expressed in larger amounts in lung cancer
Although it’s ability to combat cancer is still being studied, this study shows that it may be able to enhance the way NSCLC (non-small cell lung ca:

Dose Adjustments

N/A

The FDA approval is pending for NSCLC

600 mg orally two times a day till the disease progresses/ unacceptable toxicity
Dose reduction schedule Starting dose- 600 mg orally two times a day
First dose reduction- 450 mg orally two times a day
Second dose reduction- 300 mg orally two times a day
If patients are unable to tolerate 300 mg orally two times a day, discontinue the medication

Indicated for metastatic (HER-2 mutant) cancer in patients who have taken a prior chemotherapy
5.4 mg/kg intravenously every 3 weeks as a 21-day cycle
Continue until the disease is progressed

As adjuvant therapy:
Administer dose of 15 ml through subcutaneous route for every 3 weeks up to 12 months
As first-line treatment for metastatic disease:
Administer dose of 15 ml through subcutaneous route for every 3 weeks

Safety and efficacy not established  

Safety and efficacy not established

Refer adult dosing