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Brigatinib: A Review in ALK-Inhibitor Naïve Advanced ALK-Positive NSCLC

Sheridan M Hoy1

  • 1Springer Nature, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand. demail@springer.com.

Drugs
|February 2, 2021
PubMed

Insights

Brigatinib is an effective first-line treatment for advanced ALK-positive non-small-cell lung cancer (NSCLC), significantly improving progression-free survival and response rates compared to crizotinib.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Advanced anaplastic lymphoma kinase (ALK)-positive non-small-cell lung cancer (NSCLC) requires effective first-line therapies.
  • Tyrosine kinase inhibitors targeting ALK and ROS1 offer treatment options for NSCLC.
  • Brigatinib is an approved ALK/ROS1 inhibitor for advanced NSCLC.

Purpose of the Study:

  • To evaluate brigatinib as a first-line treatment for advanced ALK-positive NSCLC.
  • To compare the efficacy and safety of brigatinib versus crizotinib.
  • To assess intracranial response rates in patients with CNS metastases.

Main Methods:

  • A multinational, phase III clinical trial (ALTA-1L).
  • Comparison of brigatinib with crizotinib in treatment-naïve patients with advanced ALK-positive NSCLC.
  • Assessment of progression-free survival (PFS), objective response (OR) rate, and intracranial OR rate.

Main Results:

  • Brigatinib demonstrated significantly improved median PFS compared to crizotinib.
  • Higher confirmed objective response (OR) rates were observed with brigatinib.
  • Brigatinib showed improved confirmed intracranial OR rates, beneficial for patients with CNS metastases.
  • The tolerability profile of brigatinib was manageable with no new safety concerns.

Conclusions:

  • Brigatinib represents a significant advancement in first-line treatment for advanced ALK-positive NSCLC.
  • It offers superior efficacy and a manageable safety profile compared to crizotinib.
  • Brigatinib expands first-line treatment options, including for patients with central nervous system metastases.

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