Related Experiment Video
Updated: Jun 19, 2026
06:25
Ex Vivo Culture of Circulating Tumor Cells in the Cerebral Spinal Fluid from Melanoma Patients to Study Melanoma-Associated Leptomeningeal Disease
Published on: March 29, 2024
First-Line Alectinib Versus Ceritinib With or Without Brain Radiotherapy in ALK-Positive Non-Small Cell Lung Cancer
Hoang Gia Nguyen1,2, Xuan Hau Nguyen2, Phuong Nguyen3
1Lung and Breast Medical Oncology Department, Hanoi Oncology Hospital, Hanoi, Vietnam.
Thoracic Cancer
|June 18, 2026
Summary
First-line alectinib significantly improved intracranial and systemic outcomes in ALK-positive non-small cell lung cancer patients with brain metastases compared to ceritinib. Ceritinib with upfront brain radiotherapy is a viable option in resource-limited settings.
Area of Science:
- Oncology
- Pharmacology
- Clinical Trials
Background:
- Comparing first-line alectinib and ceritinib efficacy in ALK-positive non-small cell lung cancer (NSCLC) with brain metastases (BM).
- Evaluating the role of upfront brain radiotherapy (RT) in this patient population.
Purpose of the Study:
- To compare the efficacy of first-line alectinib versus ceritinib in ALK-positive NSCLC patients with BM.
- To assess the impact of upfront brain radiotherapy in conjunction with these treatments.
Main Methods:
- Retrospective analysis of 108 ALK-positive NSCLC patients with baseline BM treated with alectinib or ceritinib.
- Assessment of intracranial and systemic responses using RANO-BM and RECIST v1.1 criteria.
- Survival outcomes analyzed via Kaplan-Meier and multivariable Cox regression.
Main Results:
- Alectinib showed superior intracranial disease control (iDCR 97.6% vs. 83.3%) and longer median intracranial progression-free survival (iPFS 40.4 vs. 17.2 months) compared to ceritinib.
- Alectinib also demonstrated significantly longer systemic progression-free survival (PFS 35.9 vs. 11.5 months).
- Multivariable analysis confirmed alectinib as an independent predictor of better iPFS and systemic PFS.
Conclusions:
- First-line alectinib offers superior intracranial and systemic efficacy over ceritinib in a real-world Vietnamese cohort.
- Ceritinib combined with upfront brain RT presents a reasonable alternative in resource-limited settings.
- The potential differential benefit of brain RT between alectinib and ceritinib warrants further investigation.
Related Concept Videos
02:56Treatment Resistent Cancers
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
02:57Targeted Cancer Therapies
The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...
There are several types of targeted therapies against specific...
02:56Treatment Resistant Cancers
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...