Investigating the efficacy of Alectinib, an ALK inhibitor, in ALK-Positive Non-Small-Cell Lung Cancer
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on April 29th, 2024
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Approximately 5% of all cases of non-small-cell lung cancer (NSCLC) exhibit rearrangement to the anaplastic lymphoma kinase (ALK) gene. This specific subset of NSCLC can be treated with platinum-based combination chemotherapy; however, this regimen has modest improvements to the survival rate and it has a relatively high risk of disease recurrence. Alectinib is an ALK inhibitor, and a study has been conducted to assess its efficacy in managing ALK-positive NSCLC.
The phase 3 clinical trial included 257 patients who had been diagnosed with ALK-positive non-small-cell lung cancer. Using the criteria set by the American Joint Committee on Cancer and Union for International Cancer Control, the study included 130 stage IIIA patients, 88 stage II patients, and 39 stage IB patients with tumors larger than 4 cm. Almost all patients had undergone lobectomy for tumor resection. The patients were randomly assigned to be treated with alectinib or the platinum-based chemotherapy. Alectinib was administered orally at a dose of 600 mg twice a day for 24 months. For the intravenous chemotherapy, a combination of cisplatin, vinorelbine, and gemcitabine was administered in four 21-day cycles. Specifically, cisplatin was given at a dosage of 75 mg per square meter of body-surface area on day 1 of each cycle, vinorelbine at 25 mg per square meter (on days 1 and 8), and gemcitabine at 1250 mg per square meter (on days 1 and 8). Upon completion of the study, the researchers found that in patients in stage II and IIIa, alectinib reduced the risk of death and disease recurrence by 24%. Alectinib usage also reduced the risk of metastases to the central nervous system by 22%.
The phase 3 clinical trial included 257 patients who had been diagnosed with ALK-positive non-small-cell lung cancer. Using the criteria set by the American Joint Committee on Cancer and Union for International Cancer Control, the study included 130 stage IIIA patients, 88 stage II patients, and 39 stage IB patients with tumors larger than 4 cm. Almost all patients had undergone lobectomy for tumor resection. The patients were randomly assigned to be treated with alectinib or the platinum-based chemotherapy. Alectinib was administered orally at a dose of 600 mg twice a day for 24 months. For the intravenous chemotherapy, a combination of cisplatin, vinorelbine, and gemcitabine was administered in four 21-day cycles. Specifically, cisplatin was given at a dosage of 75 mg per square meter of body-surface area on day 1 of each cycle, vinorelbine at 25 mg per square meter (on days 1 and 8), and gemcitabine at 1250 mg per square meter (on days 1 and 8). Upon completion of the study, the researchers found that in patients in stage II and IIIa, alectinib reduced the risk of death and disease recurrence by 24%. Alectinib usage also reduced the risk of metastases to the central nervous system by 22%.