Dr. Saxena on the Future of 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 the future of next-generation ALK inhibitors in non—small cell lung cancer (NSCLC).

Alectinib (Alecensa) and brigatinib (Alunbrig) have not been compared in a head-to-head clinical trial, says Saxena.

It appears that brigatinib has a higher sensitivity to certain resistance mutations versus alectinib, adds Saxena. However, it is unknown whether that translates to a longer progression-free survival.

The question of what to give patients who progress on a second-line ALK inhibitor like lorlatinib (Lorbrena) remains an area of active investigation, explains Saxena. Likely, chemotherapy would be the optimal option; however, potential novel agents and combination strategies are under evaluation.