ESMO 2023 | Assessing the efficacy of alectinib versus crizotinib in ALK-positive NSCLC

Marco Tagliamento, MD, Gustave Roussy, Villejuif, France, presents a post-hoc patient-level pooled analysis of alectinib versus crizotinib from the Phase III ALEX (NCT02075840) and J-ALEX (JapicCTI-132316) trials in ALK-positive advanced non-small cell lung cancer (NSCLC) naïve to ALK inhibitors. The primary endpoint in both studies was progression-free survival (PFS). The analysis includes 500 patients, with alecensa showing significantly prolonged PFS over crizotinib. Multivariate analysis reveals that high tumor burden (hTB) is a prognostic factor for worse PFS regardless of treatment, while a body mass index (BMI) ≥25 is linked to better overall-survival (OS). Subgroup analysis indicates a significant interaction between treatment and TB. Adverse events were lower with alecensa. The findings suggest the importance of considering hTB and BMI in treatment decisions for advanced ALK+ NSCLC. This interview took place at the European Society for Medical Oncology (ESMO) 2023 Congress in Madrid, Spain.

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