The brigatinib experience: a new generation of therapy for ALK-positive non-small-cell lung cancer

Future Oncol. 2018 Aug;14(19):1897-1908. doi: 10.2217/fon-2017-0545. Epub 2018 Feb 16.

Abstract

Lung cancer remains the leading cause of cancer deaths in the world with 1.69 million deaths in 2015. A total of 85% of lung cancer cases are non-small-cell lung cancers (NSCLCs). Driver mutations associated with anaplastic lymphoma kinase (ALK) have been identified in a variety of malignancies, including NSCLC. An ALK inhibitor (crizotinib, ceritinib and alectinib) is the preferred therapeutic approach to those advanced ALK fusion variant-positive NSCLC patients. Brigatinib, a next-generation ALK inhibitor, shows promising activity in ALK-rearranged NSCLC that have previously received crizotinib with response rates in ALTA ranging from 42-50%, intracranial response 42-67% and median progression-free survival 9.2-12.9 months. Randomized Phase III trial, ALTA-1 L is investigating brigatinib in ALK inhibitor-naive patients.

Keywords: ALK; ALTA; EML4–ALK rearrangement; NSCLC; alectinib; brigatinib; central nervous system metastases; ceritinib; crizotinib; lung cancer.

Publication types

  • Clinical Trial, Phase III
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Anaplastic Lymphoma Kinase
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / genetics
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Central Nervous System Neoplasms / drug therapy*
  • Central Nervous System Neoplasms / genetics
  • Central Nervous System Neoplasms / pathology
  • Crizotinib
  • Disease-Free Survival
  • Drug Resistance, Neoplasm / drug effects
  • Female
  • Gene Expression Regulation, Neoplastic
  • Humans
  • Male
  • Middle Aged
  • Mutation
  • Neoplasm Proteins / genetics
  • Oncogene Proteins, Fusion / genetics
  • Organophosphorus Compounds / administration & dosage*
  • Organophosphorus Compounds / adverse effects
  • Pyrazoles / administration & dosage
  • Pyrazoles / adverse effects
  • Pyridines / administration & dosage
  • Pyridines / adverse effects
  • Pyrimidines / administration & dosage*
  • Pyrimidines / adverse effects
  • Receptor Protein-Tyrosine Kinases / antagonists & inhibitors
  • Receptor Protein-Tyrosine Kinases / genetics*

Substances

  • Neoplasm Proteins
  • Oncogene Proteins, Fusion
  • Organophosphorus Compounds
  • Pyrazoles
  • Pyridines
  • Pyrimidines
  • Crizotinib
  • ALK protein, human
  • Anaplastic Lymphoma Kinase
  • Receptor Protein-Tyrosine Kinases
  • brigatinib