Dr. Mok on Overall Survival Data From the ALEX Trial in ALK+ Lung Cancer

Tony S. K. Mok, MD, BMSc, FRCPC, chairman, Department of Clinical Oncology, Li Shu Fan Professor of Clinical Oncology, The Chinese University of Hong Kong, discusses overall survival from the phase III ALEX trial in ALK-positive lung cancer.

In the ALEX trial, patients with newly diagnosed ALK-positive NSCLC were randomized to receive alectinib (Alecensa) versus crizotinib (Xalkori). Data presented at the 2019 ESMO Congress showed that the median overall survival had yet to be reached in the alectinib arm versus the crizotinib arm. However, the 4-year OS rate was 64.5% (95% CI, 55.6-73.4) in the alectinib arm versus 52.2% (95% CI, 42.6-64.8) in the crizotinib arm. In terms of safety, fewer patients on alectinib experienced grade ≥3 adverse events versus those on crizotinib, at 48.7% and 55.0%, respectively.

In 2017, the FDA approved alectinib for the frontline treatment of patients with ALK-positive NSCLC based on favorable progression-free survival data from the ALEX trial. As such, alectinib was adopted as the frontline standard of care for this patient population. Data from the OS analysis confirm that alectinib should remain the frontline standard, concludes Mok.