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In first-line and second-line phase III trials of individuals with ALK-rearranged, non-small cell lung cancer (NSCLC), crizotinib was shown to be more active than standard chemotherapy, states Mark A. Socinski, MD. Crizotinib is orally administered, well tolerated, and the preferred option for initial treatment of patients with ALK-positive NSCLC. Toxicities include vision abnormalities and nausea.
Ceritinib is a second-generation ALK inhibitor that is 20 to 50 times more potent than crizotinib, says Socinski. This agent is active in individuals who were previously treated with ALK inhibition and developed resistance or progressed, as well as individuals who are treatment-naïve. Its current indication is in second-line treatment, following crizotinib exposure.