lung cancer

Brigatinib Versus Crizotinib in Advanced ALK Inhibitor–Naive ALK-Positive Non–Small Cell Lung Cancer: Second Interim Analysis of the Phase III ALTA-1L Trial

In the November 1, 2020 edition of Journal of Clinical Oncology , D. Ross Camidge and colleagues report on the results of the phase III ALTA-1L trial

PURPOSE

In this publication, investigators report on the second prespecified intermittent analysis of 150 events of the phase 3 ALTA-1L trial with brigatinib versus crizotinib, and ALK positive advanced nontreated non-small cell lung cancer.

METHODS

After randomization in a 1:1 fashion, patients with ALK inhibitor–naive advanced ALK-positive NSCLC were treated with either brigatinib 180 mg once daily or crizotinib 250 mg twice daily. The primary end point was progression free survival.

RESULTS

275 patients were randomized (brigatinib, n = 137; crizotinib, n = 138). After a median follow-up of 24.9 months for brigatinib (150 PFS events), brigatinib showed consistent superiority in PFS versus crizotinib (HR, 0.49 [95% CI, 0.35 to 0.68]; log-rank P < .0001; median, 24.0 v 11.0 months). Investigator-assessed PFS hazard ratio was 0.43 (95% CI, 0.31 to 0.61; median, 29.4 v 9.2 months). No new safety concerns emerged. Brigatinib was shown to delay the median time to worsening of global health status/QoL scores compared to crizotinib (HR, 0.70 [95% CI, 0.49 to 1.00]; log-rank P = .049). 

The authors concluded “ Brigatinib represents a once-daily ALK inhibitor with superior efficacy, tolerability, and QoL over crizotinib, making it a promising first-line treatment of ALK-positive NSCLC.”

Reference:

Brigatinib Versus Crizotinib in Advanced ALK Inhibitor–Naive ALK-Positive Non–Small Cell Lung Cancer: Second Interim Analysis of the Phase III ALTA-1L Trial

https://ascopubs.org/doi/full/10.1200/JCO.20.00505

en_USEnglish