Is Caplyta Contraindicated in Laryngeal Cancer?
No, treatment with Caplyta (lumateperone) is not contraindicated in patients with laryngeal cancer. The only contraindication for Caplyta is a history of hypersensitivity reaction to lumateperone, including pruritus, rash, or urticaria 1.
FDA-Approved Contraindications
The FDA prescribing information for Caplyta lists only one contraindication 1:
- Hypersensitivity reactions to lumateperone (manifesting as pruritus, allergic dermatitis, papular rash, generalized rash, or urticaria)
Cancer, including laryngeal cancer, is not listed as a contraindication in the FDA label 1.
Clinical Context and Considerations
Caplyta's Approved Indications
Caplyta is FDA-approved for 1:
- Schizophrenia in adults
- Depressive episodes associated with bipolar I or II disorder in adults (as monotherapy or adjunctive therapy with lithium or valproate)
Relevant Warnings for Cancer Patients
While laryngeal cancer itself is not a contraindication, clinicians should be aware of specific warnings 1:
- Elderly patients with dementia-related psychosis have increased mortality risk with antipsychotic drugs (1.6-1.7 times higher than placebo), though Caplyta is not approved for this indication 1
- Cerebrovascular adverse reactions including stroke have been observed in elderly dementia patients treated with antipsychotics 1
Laryngeal Cancer Treatment Does Not Preclude Caplyta Use
Standard laryngeal cancer treatment involves 2, 3:
- Concurrent cisplatin-based chemoradiation for advanced disease
- Surgical approaches (endoscopic resection, partial or total laryngectomy) for early-stage disease
- TPF induction chemotherapy for larynx preservation in select cases
None of these oncologic treatments create a contraindication to Caplyta if the patient requires treatment for schizophrenia or bipolar depression 1.
Practical Clinical Approach
If a patient with laryngeal cancer requires antipsychotic or mood stabilization therapy:
- Verify no history of hypersensitivity to lumateperone before prescribing 1
- Assess for drug interactions with CYP3A4 inhibitors, as cisplatin-based chemotherapy regimens may involve concurrent medications; dose adjustment to 21 mg or 10.5 mg daily may be needed with moderate or strong CYP3A4 inhibitors 1
- Monitor for suicidal thoughts in patients being treated for bipolar depression, particularly in those under age 25 1
- Consider hepatic function, as patients with moderate-to-severe hepatic impairment require dose reduction to 21 mg daily 1
The decision to use Caplyta should be based on psychiatric indication and the absence of hypersensitivity, not on the presence of laryngeal cancer.