Dr. Saxena on Available Next-Generation ALK Inhibitors in NSCLC

Ashish Saxena, MD, PhD, assistant attending physician, NewYork-Presbyterian Hospital, assistant professor of medicine, Weill Cornell Medical College, discusses available next-generation ALK inhibitors in non—small cell lung cancer (NSCLC).

The frontline standard of care for patients with ALK-mutated NSCLC is an ALK TKI, says Saxena.

Currently, crizotinib (Xalkori), ceritinib (Zykadia), and alectinib (Alecensa) are approved for the first-line treatment of ALK-positive metastatic NSCLC. Another agent, brigatinib (Alunbrig) is approved for ALK-positive patients who have progressed on or are intolerant of crizotinib. More recently, brigatinib has shown promise as a first-line option, explains Saxena.

Crizotinib was the prior standard of care in the frontline setting; however, alectinib and brigatinib demonstrated an improvement in progression-free survival versus crizotinib in head-to-head trials.

Additionally, lorlatinib (Lorbrena) was approved in 2018 for the treatment of patients with ALK-positive metastatic NSCLC who progressed on crizotinib and at least one other ALK inhibitor; alectinib as the first ALK inhibitor for metastatic disease; or ceritinib as the first ALK inhibitor for metastatic disease.