ALK Inhibitors in ALK+ Non-Small Cell Lung Cancer

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In an indirect comparison, brigatinib appeared to have greater efficacy than alectinib or ceritinib in ALK+ non-small cell lung cancer.
In an indirect comparison, brigatinib appeared to have greater efficacy than alectinib or ceritinib in ALK+ non-small cell lung cancer.
The following article features coverage from the 2017 Hematology/Oncology Pharmacy Association (HOPA) Annual Conference in Anaheim, California. Click here to read more of Cancer Therapy Advisor's conference coverage.

In an indirect comparison, brigatinib appeared to have greater efficacy than alectinib or ceritinib in ALK+ non-small cell lung cancer (NSCLC), according to a poster presented at the 2017 Hematology/Oncology Pharmacy Association Annual Conference.1

ALK inhibitors are efficacious in ALK+ NSCLC, but many patients progress within 12 months. Several new ALK inhibitors are emerging, though no head-to-head trials have been conducted. The aim of this study was an indirect comparison of safety and efficacy among these agents.

This study collected data from pivotal trials, post-crizotinib studies, and prescribing information to evaluate patient characteristics and clinical outcomes from 663 patients treated with alectinib, brigantine, or ceritinib.

The authors identified several confounders across the trials. The brigatinib trials (NCT01449461, NCT02094573) included fewer patients with an Eastern Cooperative Oncology Group (ECOG) performance status of 2, which potentially favored brigatinib. The alectinib trials (NCT01871805, NCT01801111) had a higher number of patients with baseline central nervous system metastases, which potentially favored alectinib. The ceritinib studies (NCT01283516, NCT01685060) included a lower proportion of Asian patients, which potentially favored ceritinib.

Brigatinib resulted in a numerically higher objective response rate, duration of response, and median progression-free survival compared with alectinib and ceritinib. Duration of response was longer with brigatinib or alectinib compared with ceritinib.

Rates of discontinuation due to adverse events were similar among the 3 agents, though more patients taking ceritinib required dose reductions.

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According to the authors, the results of this indirect comparison suggest that “brigatinib may have a favorable efficacy and acceptable safety profile compared with currently available therapies.”

Read more of Cancer Therapy Advisor's coverage of the 2017 Hematology/Oncology Pharmacy Association (HOPA) Annual Conference by visiting the conference page.

Reference

  1. Reckamp KL, Huang JT, Huang H, Moore Y. Indirect naïve comparison of anaplastic lymphoma kinase inhibitors for ALK+ non–small-cell lung cancer after crizotinib failure. Poster presented at: 13th Hematology/Oncology Pharmacy Association Annual Conference; March 29-April 1, 2017; Anaheim, CA. 

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