Common Adverse Reactions of Repotrectinib

Common Adverse Reactions of Repotrectinib

The safety of Repotrectinib was evaluated in 426 patients in the TRIDENT-1 study. Overall, most adverse reactions were Grade 1 or 2, but some patients experienced Grade 3 or 4 serious events. The most common adverse reactions (incidence ≥20%) included dizziness, dysgeusia, peripheral neuropathy, constipation, dyspnea, fatigue, ataxia, cognitive impairment, myasthenia, and nausea. These adverse reactions cover the nervous system, digestive system, respiratory system, and systemic symptoms. Among them, nervous system-related reactions (dizziness, dysgeusia, peripheral neuropathy, ataxia, cognitive impairment) were the most prominent.

Detailed Description of the Most Common Adverse Reactions of Repotrectinib

Dizziness was the most frequently reported adverse reaction, with an incidence of 65%, including vertigo. Dysgeusia (taste abnormality or loss) also occurred at a high rate and may affect patient appetite and quality of life. Peripheral neuropathy manifested as paresthesia, numbness, burning sensation, etc., with incidence not specifically listed but among the most common. Constipation and nausea were common gastrointestinal reactions. Dyspnea (including exertional dyspnea) and fatigue significantly impacted daily activities. Ataxia often presented as gait and balance disorders. Cognitive impairment included memory decline and attention deficits. Myasthenia may manifest as limb weakness. Most of these reactions are manageable but require close monitoring.

Management Strategies for Adverse Reactions of Repotrectinib

For the above adverse reactions, physicians should adopt individualized management strategies. For dizziness and ataxia, patients are advised to avoid driving and hazardous activities, and fall prevention measures should be considered. For dysgeusia, dietary flavor adjustments may be helpful. For peripheral neuropathy, neurotrophic drugs or dose adjustment can be considered. For constipation, laxatives or dietary modification may be used. For dyspnea, interstitial lung disease should be ruled out. For fatigue, adequate rest and nutritional support are encouraged. For cognitive impairment, cognitive training may be performed. For myasthenia, creatine phosphokinase levels should be monitored. The general principle is to withhold, reduce, then resume dosing or permanently discontinue based on severity. Patient education is crucial; patients should be advised to promptly report any new or worsening symptoms.