WCLC 2019: Final Data From ALUR Trial of Alectinib in Pretreated Lung Cancer
Posted: Monday, September 9, 2019
Juergen Wolf, MD, of the Center for Integrated Oncology, University Hospital Cologne, Germany, and colleagues reported that final data from the phase III ALUR trial confirm the primary analysis: the ALK inhibitor alectinib improved efficacy and safety compared with chemotherapy in patients with ALK-positive non–small cell lung cancer (NSCLC) after treatment with the ALK inhibitor crizotinib. These study findings were presented at the International Association for the Study of Lung Cancer 2019 World Conference on Lung Cancer (WCLC) in Barcelona (Abstract OA02.07).
“The role of reconfirming ALK status upon sequential ALK inhibitor treatment requires further investigation,” the investigators concluded, “due to the limited data and known technical challenges of plasma testing.”
Participating in the ALUR trial were 119 patients with locally determined ALK-positive NSLCC. They were randomly assigned 2:1 to receive 600 mg of alectinib twice daily or chemotherapy (500 mg/m2 of pemetrexed or 75 mg/m2 of docetaxel every 3 weeks). In addition, using tumor tissue (n = 33) and baseline plasma (n = 59), targeted genomic sequencing was performed.
The median progression-free survival (primary study endpoint) was longer in the 79 patients treated with alectinib than in the 40 patients treated with chemotherapy (10.9 vs. 1.4 months). As for toxicity, the incidence of grade ≥ 3 treatment-emergent adverse events was lower with alectinib than with chemotherapy (37.7% vs. 43.2%).
Retrospectively, the investigations confirmed ALK fusions in 78.8% of tissue and 69.5% of plasma (postcrizotinib) samples. The objective response rate was higher at 72.2% (in tissue) and 63.0% (in plasma) in those with ALK fusions treated with alectinib than at 0% (both in tissue and plasma) in those treated with chemotherapy.
Disclosure: The study authors’ disclosure information may be found at wclc2019.iaslc.org.