Alectinib vs Crizotinib in Treatment-Naive ALK+ NSCLC


Alectinib vs Crizotinib in Treatment-Naive ALK+ NSCLC: CNS Efficacy Result From The ALEX Study [1298O_PR]

Professor Shirish Gadgeel, et al reported that alectinib showed significantly superior CNS activity versus crizotinib in patients with CNS disease in previously untreated advanced ALK+ve NSCLC.

  • Median PFS was longer in patients treated with alectinib compared with crizotinib, irrespective of CNS metastases at baseline
    • Patients with CNS metastases at baseline: NR (N=64) vs 7.4 months (N=58), HR = 0.40, P<0.0001
    • Patients without CNS metastases at baseline: NR (N=88) vs 14.8 months (N=93), HR = 0.51, P=0.0024
  • Cumulative incidence rate of CNS progression was lower in patients treated with alectinib compared with crizotinib, irrespective of CNS metastases at baseline
    • Patients with CNS metastases at baseline: 16.0% (N=64) vs 58.3% (N=58), HR = 0.18, P<0.0001
    • Patients without CNS metastases at baseline: 4.6% (N=88) vs 31.5% (N=93), HR = 0.14, P<0.0001
  • Intracranial ORR was improved in patients treated with alectinib compared with crizotinib, irrespective of prior radiotherapy
    • Patients with prior RT: 85.7% vs 71.4%
    • Patients without prior RT: 78.6% vs 40%

The CNS results from ALEX trial suggests alectinib is protective against the development of CNS progression and consolidate alectinib as the new standard of care for patients with previously untreated, advanced ALK+ve NSCLC.

http://www.esmo.org/Press-Office/Press-Releases/Alectinib-ALEX-and-ALUR-Trials-Show-CNS-Benefit-in-NSCLC

 

Oscar Ma
Associate Manager, Medical Affairs
Lung Franchise
e-mail: oscar.ma@roche.com