Alectinib for treatment of ALK-positive non-small-cell lung cancer

Virginie Avrillon1, Maurice Pérol1

  • 1Department of Medical Oncology, Léon Bérard Cancer Center, Lyon, France.

Insights

Alectinib shows superior progression-free survival compared to crizotinib in ALK-positive non-small-cell lung cancer (NSCLC). This positions alectinib as a potential frontline treatment for ALK-positive NSCLC patients.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Alectinib is a second-generation ALK inhibitor effective against crizotinib resistance mutations.
  • It demonstrates good central nervous system penetration and a favorable safety profile.

Purpose of the Study:

  • To review therapeutic options for ALK-positive advanced non-small-cell lung cancer (NSCLC).
  • To summarize the chemical, pharmacodynamic, pharmacokinetic, metabolic, and clinical efficacy data of alectinib.

Main Methods:

  • Review of Phase II and Phase III clinical trial data, including J-ALEX and expected ALEX study results.
  • Analysis of preclinical and clinical data on alectinib's properties.

Main Results:

  • Alectinib is approved for pretreated ALK-positive NSCLC patients in Japan and by the US FDA.
  • The Phase III J-ALEX study demonstrated alectinib's superiority over crizotinib in progression-free survival for crizotinib-naive patients.

Conclusions:

  • Alectinib exhibits significant efficacy and a good safety profile in ALK-positive NSCLC.
  • Results suggest alectinib may become a preferred frontline therapy for ALK-positive NSCLC.