ASCO 2017: Alectinib vs Crizotinib in ALK-Positive Lung Cancer
In patients with ALK-positive non–small cell lung cancer (NSCLC), alectinib delayed cancer growth for more than a year longer than the current standard of care crizotinib, according to the primary results of the phase III ALEX study. These findings were presented by lead author Alice T. Shaw, MD, PhD, Director of Thoracic Oncology, Massachusetts General Hospital Cancer Center, at the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract LBA9008).
A total of 303 treatment-naive patients with ALK-positive NSCLC were randomized 1:1 to receive alectinib or crizotinib. When compared with crizotinib, alectinib reduced the risk of cancer progression or death by 53%, extended the median time to disease progression by about 15 months, and was associated with fewer severe side effects.
“This is the first global study to compare alectinib with crizotinib in ALK-positive lung cancer and establishes alectinib as the new standard of care for initial treatment in this setting,” reported Dr. Shaw.
Furthermore, alectinib seemed to be more effective in preventing brain metastases than crizotinib. At 12 months, the incidence of brain metastases was 9% with alectinib, versus 41% with crizotinib. Patient follow-up will continue to determine whether those treated with alectinib live longer than those treated with crizotinib.