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ESMO Asia 2017: Alectinib vs. Crizotinib in Asian Patients With Lung Cancer

By: Susan Reckling
Posted: Monday, November 20, 2017

Alectinib (at 600 mg twice daily) appears to be more effective than the standard-of-care crizotinib in Asian patients with treatment-naive anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC), based on a subanalysis of the phase III ALEX trial. In addition, the ALEX trial subsequently reported improvement in progression-free survival with alectinib at the same dosage regimen in a global population with ALK-positive NSCLC. These findings were presented by Tony S.K. Mok, MD, FASCO, of the Chinese University of Hong Kong at the European Society for Medical Oncology (ESMO) Asia 2017 Congress in Singapore (Abstract 410O_PR).

As previously reported, the ALEX trial included 303 patients, who were randomized to receive alectinib or crizotinib. There were 69 Asian patients in each treatment group.

The subanalysis showed similar efficacy and safety with alectinib in both Asian and non-Asian patients. Progression-free survival was longer with alectinib than with crizotinib in Asian and non-Asian populations, with hazard ratios of 0.46 and 0.49, respectively. In addition, alectinib reduced central nervous system disease progression compared with crizotinib in both Asian and non-Asian groups. Comparable rates of toxicity were reported.

“The findings suggest that 600 mg should be the standard dose of alectinib across Asia,” declared Dr. Mok in an ESMO press release.