Table 3. QT Prolongation Monitoring Recommendations.
| Medication | FDA-approved indications | QTcP frequency | Monitoring recommendations |
|---|---|---|---|
| Asciminib | Philadelphia chromosome–positive chronic myelogenous leukemia | 1%–10% | Monitor if history of cardiovascular risk factors |
| Adagrasib | Non–small cell lung cancer | 10%–30% | ECG and electrolytes at baseline, and as clinically necessary for high-risk patients |
| Bosutinib | Chronic myelogenous leukemia | 1%–10% | NA |
| Ceritinib | Non–small cell lung cancer | 1%–10% to 10%–30% | ECG and electrolytes periodically in high-risk patients |
| Crizotinib | Non–small cell lung cancer | 1%–10% | ECG and electrolytes in high-risk patients |
| Dasatinib | Chronic myelogenous leukemia, acute lymphoblastic leukemia | < 1% | ECG in high-risk patients |
| Encorafenib | Melanoma | < 1% | Monitor high-risk patients |
| Entrectinib | Non–small cell lung cancer, solid tumors | 1%–10% | ECG and electrolytes at baseline and periodically |
| Gilteritinib | Acute myeloid leukemia | 1%–10% | ECG at baseline on days 8 and 15 of cycle 1, and before the start of the next two subsequent treatment cycles |
| Glasdegib | Acute myeloid leukemia | 1%–10% | ECG at baseline, 1 week after initiation, once monthly for 2 months following initiation, and as clinically necessary |
| Ivosidenib | Acute myeloid leukemia | 10%–30% | ECG at baseline, at least once weekly for the first 3 weeks of therapy, and once monthly for duration of therapy. Monitor electrolytes at baseline and periodically |
| Lapatinib | Breast cancer | < 1% | Consider ECG at baseline and periodically in high-risk patients |
| Lenvatinib | Renal cell carcinoma, hepatocellular carcinoma, thyroid cancer, endometrial carcinoma | 1%–10% | ECG and electrolytes in high-risk patients |
| Midostaurin | Acute myeloid leukemia, mast cell leukemia | 10%–30% | Consider ECG in high-risk patients |
| Mobocertinib | Non–small cell lung cancer | 1%–10% | ECG and electrolytes at baseline and as clinically necessary. Avoid strong and moderate CYP3A inhibitors or drugs known to prolong QTc interval |
| Nilotinib | Chronic myelogenous leukemia | 1%–10% | ECG and electrolytes at baseline. ECG at 7 days and with dose change |
| Osimertinib | Non–small cell lung cancer | 1%–10% | Monitor ECG and electrolytes periodically in high-risk patients |
| Pacritinib | Myelofibrosis | 1%–10% | ECG and electrolytes at baseline and periodically. |
| Pazopanib | Renal cell carcinoma, soft tissue sarcoma | 1%–10% | ECG and electrolytes at baseline and periodically |
| Ribociclib | Breast cancer | 1%–10% | ECG at baseline, at day 14 of cycle 1, at start of cycle 2, and as clinically indicated. Electrolytes at baseline and at beginning and end of the first six cycles. |
| Selpercatinib | Lung cancer, thyroid cancer | 10%–30% | Assess QT interval, electrolytes, and TSH at baseline and periodically during treatment. Monitor QT interval more frequently when used with strong and moderate CYP3A inhibitors or drugs known to prolong QTc interval |
| Sorafenib | Renal cell cancer, hepatocellular cancer, differentiated thyroid cancer | < 1% | ECG and electrolytes in high-risk patients |
| Sunitinib | Renal cell carcinoma, GIST, pancreatic neuroendocrine tumor | < 1% | Consider ECG at baseline and periodically with electrolytes |
| Vandetanib | Medullary thyroid cancer | 10%–30% | Monitor electrolytes at baseline and periodically. ECG at baseline, 2–4 weeks, and 8–12 weeks after initiation, then every 3 months or as clinically necessary |
| Vemurafenib | Melanoma | 30%–50% to > 50% | Monitor electrolytes at baseline and with dosage adjustments. Monitor ECG at baseline, 15 days post initiation, then monthly for 3 months, then every 3 months thereafter and with dose adjustments |
| Vorinostat | Cutaneous T-cell lymphoma | 1%–10% | NA |
Note. NA = not available; FDA = US Food and Drug Administration; QTcP = prolongation of the corrected QT interval on the ECG; ECG = electrocardiogram; GIST = gastrointestinal stromal tumor; TSH = thyroid stimulating hormone. Information from Lexicomp (2022); Micromedex (2022).