Surprising result with Alectinib in ALK-positive lung cancer

Alectinib, a drug targeting the ALK fusion gene for lung cancer treatment, was found to extend time without disease worsening by approximately 15 months compared with Crizotinib, while also preventing brain metastases more effectively.

Study

The Japanese J-ALEX study enrolled patients who had not previously received systemic treatment for advanced lung cancer, with stage 3B or stage 4 non-small cell lung cancer, totaling 303 patients.

The study’s most important result was that Alectinib reduced the risk of death or disease progression by %53 compared with Crizotinib. It substantially extended progression-free survival—the time from starting treatment until disease worsening—by approximately 15 months (25.7 versus 10.4 months). Although both drugs cross the blood-brain barrier, Alectinib was also more effective in preventing lung cancer spread to the brain (brain metastasis). Better penetration into brain tissue is thought to explain this.

When Alectinib and Crizotinib were compared for side effects, there was no marked difference, although serious side effects were more frequent with Crizotinib.

Conclusion

We can say these results begin a new, exciting era for ALK-positive lung cancer. In the coming period, Alectinib may replace Crizotinib as standard first-line treatment for ALK-positive lung cancer.

- You may be interested in: What is ALK fusion? What does an ALK mutation mean in lung cancer?