HL7® FHIR® Te Aho o Te Kahu, Cancer Control Agency Implementation Guide
0.1.0 - CI Build

HL7® FHIR® Te Aho o Te Kahu, Cancer Control Agency Implementation Guide, published by Te Aho o Te Kahu, Cancer Control Agency. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7NZ/cca/ and changes regularly. See the Directory of published versions

## PlanDefinition: LUNG NSCLC NON-Metastatic - alectinib

Official URL: https://fhir.nzf.org.nz/fhir/PlanDefinition/52401000210103 | Version: 0.1.0
Active as of 2026-05-21 | Computable Name: LUNG NSCLC NON-Metastatic - alectinib
Other Identifiers: http://snomed.info/sct#SNOMED CT International Edition#52401000210103
Usage:Clinical Focus: Malignant neoplasm of respiratory system (disorder), Clinical Focus: Non-small cell lung cancer
Copyright/Legal: All rights reserved.

A drug treatment regimen for Respiratory Non small cell lung cancer NON-Metastatic - alectinib

# LUNG NSCLC NON-Metastatic - alectinib

## Treatment Overview

## Cycle 1 (and all further cycles) - 28 days

Cycle length:
28

## Cycle details

## Cycle 1 (and all further cycles) - 28 days

Medication | Dose | Route | Days | Max Duration
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration | 1 to 28 |
loperamide | 2 mg flat | oral administration | 1 |
domperidone | 10 mg flat Three times daily | oral administration | 1 |

## Full details

## Cycle 1 (and all further cycles) - 28 days

### Day: 1

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
loperamide | 2 mg flat | oral administration |  | Instructions: Take TWO capsules (=4 mg) at onset of loose bowel motions and a further ONE capsule (=2 mg) for every loose bowel motion (maximum of EIGHT capsules in 24 hours), or use as directed by oncologist or haematologist.
domperidone | 10 mg flat Three times daily | oral administration |  | Instructions: When required for nausea and/or vomiting.

### Day: 2

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 3

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 4

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 5

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 6

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 7

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 8

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 9

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 10

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 11

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 12

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 13

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 14

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 15

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 16

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 17

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 18

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 19

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 20

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 21

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 22

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 23

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 24

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 25

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 26

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 27

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

### Day: 28

Medication | Dose | Route | Max duration | Details
--- | --- | --- | --- | ---
alectinib | 600 mg flat Twice daily | oral administration |  | Instructions: Take with food. Swallow whole, do not crush or chew. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.

## Supportive Care Factors

Factor | Value
--- | ---
Diarrhoea risk: | Anti-diarrhoeals are usually prescribed with this treatment
Emetogenicity: | Minimal

## References

1. Peters, S., D. R. Camidge, A. T. Shaw, et al. 2017. "Alectinib versus Crizotinib in Untreated ALK-Positive Non-Small-Cell Lung Cancer." N Engl J Med 377(9):829-838., PMID: 28586279

2. Hida, T., H. Nokihara, M. Kondo et al. 2017. "Alectinib versus crizotinib in patients with ALK-positive non-small-cell lung cancer (J-ALEX): an open-label, randomised phase 3 trial." Lancet 390(10089):29-39., PMID: 28501140

3. Camidge, D. R, Rafal D, Solange P, 2019. "Updated Efficacy and Safety Data and Impact of the EML4-ALK Fusion Variant on the Efficacy of Alectinib in Untreated ALK-Positive Advanced Non–Small Cell Lung Cancer in the Global Phase III ALEX Study." Journal of Thoracic Oncology 14(7):1233-1243., PMID: 30902613

4. Roche Products (New Zealand) Limited. Alecensa New Zealand Data Sheet 16 August 2018. https://www.medsafe.govt.nz/profs/Datasheet/a/alecensacap.pdf (Accessed 02 December 2020)

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.