The phase 3 ALTA-1L trial randomly assigned 275 ALK-positive advanced NSCLC patients who had not previously received ALK inhibitors to either receive brigatinib 180 mg once daily or crizotinib 250 mg twice daily. The first interim analysis results (99 events) were presented at the 19th World Conference on Lung Cancer and simultaneously published in the New England Journal of Medicine. The estimated 12-month PFS rate with brigatinib was 67% (95% CI, 56-75) vs 43% (95% CI, 32-53) with crizotinib (HR=0.49; 95% CI, 0.33-0.74; p<0.001). The objective response rate was 71% (95% CI, 62-78) with brigatinib and 60% (95% CI, 51-68) with crizotinib. The rate of intracranial response rate among patients with measurable lesions was 78% (95% CI, 52-94) and 29% (95% CI, 11-52), respectively. This study shows that brigatinib represents a promising new first-line treatment option for ALK-positive non-small cell lung cancer patients.
Camidge DR, et al. N Engl J Med. 2018; doi: 10.1056/NEJMoa1810171.