Brigatinib for ALK-Positive, Non–Small-Cell Lung Cancer

Patients with anaplastic lymphoma kinase (ALK)–rearranged non–small-cell lung cancer (NSCLC) currently have the option of front-line therapy with the first-generation ALK tyrosine kinase inhibitor (TKI) crizotinib or next-generation ALK TKIs alectinib or ceritinib.

Now, investigators have conducted an industry-funded, international, randomized, open-label, phase III trial (ALTA-1L) to compare the efficacy of the next-generation ALK TKI brigatinib with that of crizotinib in 275 treatment-naive patients with advanced ALK-positive NSCLC.

The response rate was superior with brigatinib versus crizotinib, as were 12-month progression-free survival (the primary endpoint; 67% vs. 43%; hazard ratio, 0.49; P<0.001) and intracranial response (78% vs. 29…