Dr. Drilon on the Utility of Brigatinib in ALK+ NSCLC

Alexander Drilon, MD, research director, Early Drug Development, Memorial Sloan Kettering Cancer Center, discusses the utility of brigatinib (Alunbrig) in ALK-positive non—small cell lung cancer (NSCLC).

Brigatinib is a next-generation TKI designed to have activity against wild-type ALK fusions and other treatment-related resistance mechanisms, says Drilon. In April 2017, the FDA granted an accelerated approval to brigatinib for the treatment of patients with ALK-positive metastatic NSCLC who are resistant to or intolerant of crizotinib (Xalkori).

Updated results from the randomized phase III ALTA-1L trial show that brigatinib leads to superior progression-free survival versus the prior standard of care crizotinib in patients with advanced ALK-positive NSCLC who had not received a prior ALK inhibitor. Findings from the trial showed that brigatinib led to a 51% reduction in the risk of disease progression or death versus crizotinib by blinded independent review committee (BIRC) assessment (HR, 0.49; 95% CI, 0.35-0.68; log-rank P <.0001).

The BIRC-assessed median progression-free survival was 24.0 months (95% CI, 18.5—NE) with brigatinib versus 11.0 months (95% CI, 9.2-12.9) with crizotinib. The BIRC-assessed objective response rate was 74% and 62% with brigatinib and crizotinib, respectively.

Additionally, brigatinib demonstrated meaningful central nervous system activity and led to a 69% reduction in the risk of intracranial disease progression or death in patients who had brain metastases at baseline (HR, 0.31; 95% CI, 0.17-0.56).