Dr. Shaw on Alectinib as First-Line Therapy in Lung Cancer

Alice T. Shaw, MD, PhD, Director of Thoracic Oncology, Massachusetts General Hospital, discusses alectinib (Alecensa) as first-line therapy in the treatment of patients with lung cancer.

Though crizotinib (Xalkori) is currently the standard first-line therapy in lung cancer, the J-ALEX study reported out of Japan showed positive results in the alectinib population, suggesting that alectinib may be more effective than crizotinib first-line.

According to Shaw, there is more movement toward using alectinib as the preferred second-generation, second-line ALK inhibitor due to its efficacy and side effect profile. There was a response rate of 50% in crizotinib-resistant patients, an immediate progression-free survival of about 9 months, striking CNS activity, and very manageable side effects of fatigue, edema and muscle aches at grades 1/2.

Currently, there is a global ALEX study that addresses some of the problems of the original study, such as limited ethnicity range.