Crizotinib for untreated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer

Crizotinib (Xalkori, Pfizer) is an inhibitor of the anaplastic lymphoma kinase (ALK) tyrosine kinase receptor and its variants.

Crizotinib has a marketing authorisation in the UK which includes 'the first-line treatment of adults with anaplastic lymphoma kinase (ALK)-positive advanced non-small-cell lung cancer (NSCLC)'.

The summary of product characteristics lists the following as the most common adverse reactions associated with crizotinib: visual disorder, diarrhoea, nausea, vomiting, constipation, oedema, fatigue, decreased appetite, neutropenia, elevated aminotransferases, anaemia, leukopenia, neuropathy, dysgeusia, dizziness, bradycardia, abdominal pain and rash. For full details of adverse reactions and contraindications, see the summary of product characteristics.

The recommended dosage of crizotinib is 250 mg twice daily.

The list price of crizotinib is £4,689 for 60 capsules (excluding VAT; 'British national formulary' [BNF] online, accessed February 2016).

The company has a commercial arrangement (simple discount patient access scheme). This makes crizotinib available to the NHS with a discount. The size of the discount is commercial in confidence. It is the company's responsibility to let relevant NHS organisations know details of the discount.