WCLC 2018: Brigatinib Poised to Become New First-Line Treatment in ALK-Positive Lung Cancer
Posted: Monday, October 15, 2018
The first interim analysis of a brigatinib-versus-crizotinib study was reported during the Plenary Session at the International Association for the Study of Lung Cancer (IASLC) 19th World Conference on Lung Cancer (WCLC) in Toronto (Abstract PL02.03). “Brigatinib met the prespecified threshold for statistical superiority versus the standard-of-care crizotinib in the primary endpoint,” progression-free survival assessed by blinded independent review committee, noted D. Ross Camidge, MD, PhD, of the University of Colorado Cancer Center in Aurora, and colleagues.
The ongoing phase III trial, ALTA-1L, included 275 patients with stage IIIB/IV ALK-positive non–small cell lung cancer who were previously treated with a systemic therapy but not an ALK inhibitor. At data cutoff, with a median follow-up of 11.0 (brigatinib) and 9.25 months (crizotinib), the median progression-free survival had not been reached for the brigatinib cohort and was 9.8 months in the crizotinib group (P = .0001). In addition, among patients who had brain metastases at baseline (43/137 brigatinib; 47/138 crizotinib), the reduction in the risk of disease progression or death was 80% with brigatinib. Of note, the treatment discontinuation rate due to adverse events was slightly higher with brigatinib than crizotinib (11.8% vs. 8.8%).
“Early events such as progression of preexisting brain metastases in the crizotinib-treated arm seem to be driving a lot of the initial progression-free survival differences, but later on we [must look] for differences in long-term control through brigatinib’s impact on disease outside of the brain,” Dr. Camidge explained in a University of Colorado news release.
These interim results have also been published in The New England Journal of Medicine to coincide with the WCLC presentation. Overall survival and additional analyses will be performed after further follow-up.
