Alectinib Versus Crizotinib in Advanced ALK-Positive Lung Cancer
Posted: Thursday, July 19, 2018
In patients with untreated, advanced, ALK-positive non–small cell lung cancer (NSCLC), treatment with alectinib demonstrated superior efficacy versus crizotinib, regardless of baseline central nervous system (CNS) metastases. These updated efficacy and safety data from the global phase III ALEX study were presented by David Ross Camidge, MD, PhD, Director of Thoracic Oncology at the University of Colorado in Denver, and colleagues, at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 9043).
In the trial, patients with stage IIIB/IV ALK-positive NSCLC were randomized to receive 600 mg of alectinib (n = 152) or 250 mg of crizotinib daily (n = 151). Alectinib significantly reduced the risk of disease progression or death by 57% versus crizotinib: the median progression-free survival was 34.8 months with alectinib compared with 10.9 months with crizotinib. When stratified by baseline CNS metastases, the median progression-free survival was 27.7 months with alectinib versus 7.4 months with crizotinib in patients with baseline CNS metastases and 34.8 months versus 14.7 months in patients without baseline CNS metastases.
Additionally, the proportion of patients with grades 3 to 5 adverse events or events leading to dose reduction or interruption was lower with alectinib, despite a longer treatment duration (27 months vs. 10.8 months). Approximately 13% of both arms discontinued treatment due to adverse events.
