Entretinib is used for NTRK fusion positive solid tumors and ROS1 positive NSCLC, and the following three types of adverse reactions should be given special attention.

1、 Congestive heart failure

Incidence rate: about 3% to 5%, commonly seen in patients with underlying cardiovascular diseases or in combination with antihypertensive drugs.

Monitoring: LVEF should be checked monthly at baseline and 3 months before treatment, and then every 3 months thereafter.

Treatment: Suspend medication when LVEF is less than 50% or decreases by ≥ 10% from baseline; Stop medication immediately for symptomatic heart failure and consult with a cardiologist. After recovery, consider reducing dosage (400mg/day) and restarting.

2、 Central nervous system side effects

Common manifestations: dizziness (38%), taste disorders (44%), ataxia, cognitive impairment, and emotional fluctuations.

Management: Slowly change position; Those who experience significant daytime sleepiness can take medication at night; Avoid driving and working at heights; Persistent or severe symptoms (blurred consciousness, hallucinations) require discontinuation of medication and investigation of the cause.

3、 Risk of fracture

Risk population: Individuals aged ≥ 55 or those with concomitant osteoporosis.

Prevention: DXA bone density testing before treatment for high-risk populations; Daily supplementation of calcium (1000-1200mg) and vitamin D (800-1000IU); Fall prevention education.

Treatment: When bone pain or restricted mobility occurs, X-ray/CT examination should be performed. After diagnosis, orthopedic consultation should be held. Medication should be suspended until the fracture is stable, and then reduced and restarted.