Substantial Meals Can Elevate Lung Cancer Drug Concentration

Eating substantial, high-fat meals may help patients with lung cancer get the most out of their treatment with Alecensa, recent research found.

New findings show that Alecensa (alectinib), a medication to treat advanced lung cancer, is more impactful taken with a substantial breakfast, lunch or dinner, rather than in structured doses 12 hours apart.

A substantial diet is important when taking highly concentrated drugs daily. The way in which a drug interacts with one’s body can be based on the patients’ food consumption, depending on the kind of drug.

Patients with advanced lung cancer were included in the study: half eating low-fat diets with Alecensa and the other eating high-fat diets with Alecensa. Results showed that taking Alecensa with a low-fat diet revealed 14% less exposure of the medication (observed drug levels in the body) compared to those consuming a high-fat continental breakfast. Even less exposure (20% less) was seen in patients who took Alecensa with their own designed lunch.

The study’s findings also conclude that patients can benefit from taking their medicine with a substantial meal, rather than taking the doses exactly 12 hours apart.

“To be more specific, we believe it is preferable to take the pills with breakfast and during dinner, rather than with a small snack before breakfast or somewhere in the evening”, explained study author, Daan A.C. Lanser from the Department of Medical Oncology at the Erasmus Cancer Institute, Erasmus University Medical Center, in an interview with CURE®.

When examining patients 12 hours after the most recent dose, there were no differences in side effects among the different meals studied, though Lanser mentioned that taking Alecensa with a high-fat meal may lower the risk of drug toxicity.

“(I)f (Alecensa) is better absorbed when taken with more (fatty) food, less of the drug will remain in the gastrointestinal tract. Consequently, a meal could theoretically offer some protection against gastrointestinal side effects. The second reason is that some patients may experience excessive side effects, leading physicians to consider dose reduction”, explained Lanser. “In such cases, it may be beneficial for patients to take (Alecensa) with more food/fat to partially compensate for the reduced dose.”

Overall, keeping a well-rounded diet may be beneficial to patients who are receiving Alecensa.

Lanser explains, “It's important to note that meals with some fat content can still be healthy, and most weight gain is also due to carbohydrate intake.”

This particular study was conducted over the course of a few weeks, so researchers can not provide general long-term guidance based on these findings.

“However, based on this data, we believe that taking it with an adequate amount of food containing sufficient fat is beneficial,” Lanser explained.

Other research, though, has found benefit in maintaining blood concentration levels of Alecensa for patients with lung cancer.

“Some studies have indicated that patients who maintain a certain blood concentration threshold tend to experience longer benefits from (Alecensa) treatment. When considering the potential food effect, one could speculate about potential benefits, but this has not been proven by this study,” Lanser said. “To thoroughly address these questions, a long-term follow-up study would be needed, where patients adhere to specific diets over an extended period of time.”

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