This feature has been sponsored by Takeda UK and contains promotional information C-APROM/UK//4607 August 2020
Click here to view the prescribing information for ALUNBRIG®▼(Brigatinib) Alunbrig is indicated as monotherapy for the treatment of adult patients with anaplastic lymphoma kinase (ALK) positive advanced non-small cell lung cancer (NSCLC) previously not treated with an ALK inhibitor1 Alunbrig is indicated as monotherapy for the treatment of adult patients with ALK-positive advanced NSCLC previously treated with crizotinib1
Around 3–5% of patients with NSCLC have oncogenic rearrangements in the ALK gene.2 Many of these patients are diagnosed with brain metastases at first presentation or are at risk of CNS progression,3 therefore, intracranial efficacy is important to consider when choosing the right ALK tyrosine kinase inhibitor (TKI) for the patient.
Next-generation TKIs targeting ALK are an effective treatment option for this patient group, with multiple treatments now available.4–6
As the efficacy of TKIs improves, the length of time patients spend on treatment is increased. Therefore, managing adverse events to enable patients to continue their treatment is important.
Selecting the right clinical trial endpoints is vital to help evaluate any potential treatment option more effectively for patients.
‘Why I would choose brigatinib in the post-crizotinib setting is because we have the strongest data from the literature available so far, and that comes from the ALTA study’ 2,8 – Dr Califano
The panel discuss next steps following relapse on frontline crizotinib, and what needs to be considered including when to switch following intracranial and extracranial progression.
References to support video content: 2,8
‘What are the aims of treatment in this setting? It’s at least to try and control the disease in the brain as quickly as possible… I feel as a next line of treatment, we should choose an ALK inhibitor which is a good CNS penetrant and we do have a NICE-approved option, which is brigatinib, which we know works very well intracranially and extracranially’ – Dr Califano
Reporting Adverse Events
Adverse events should be reported. In the United Kingdom, reporting forms and information can be found at www.mhra.gov.uk/yellowcard.
Adverse events should also be reported to Takeda by e-mailing DSO-UK@takeda.com.
4. National Institute for Health and Care Excellence (NICE). Brigatinib for treating ALK-positive advanced non-small-cell lung cancer after crizotinib. Published: 20 March 2019. Available at: https://www.nice.org.uk/guidance/ta571 (Accessed July 2020).
5. National Institute for Health and Care Excellence (NICE). Alectinib for untreated ALK-positive advanced non-small-cell lung cancer. Published: 8 August 2018. Available at: https://www.nice.org.uk/guidance/TA536 (Accessed July 2020).
6. National Institute for Health and Care Excellence (NICE). Ceritinib for previously treated anaplastic lymphoma kinase positive non-small-cell lung cancer. Published: 22 June 2016. Available at: https://www.nice.org.uk/guidance/ta395 (Accessed July 2020).
8. Kim DW, et al. Brigatinib in Patients With Crizotinib-Refractory Anaplastic Lymphoma Kinase–Positive Non–Small-Cell Lung Cancer: A Randomized, Multicenter Phase II Trial. J Clin Oncol 2017;35:2490-8.
9. Solomon BJ, Kim DW, Wu YL, et al. Final Overall Survival Analysis From a Study Comparing First-Line Crizotinib Versus Chemotherapy in ALK-Mutation-Positive Non-Small-Cell Lung Cancer. J Clin Oncol. 2018;36(22):2251-2258.
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