Brigatinib (Alunbrig) in all diseases

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NSCLC, ALK-positive

Source: Brigatinib (Alunbrig) for advanced or metastatic ALK-positive non-small cell lung cancer

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Regimen

FDA-recommended dose
Study Evidence Comparator Comparative Efficacy
Kim et al. 2017 (ALTA) Randomized Phase II (E-RT) Brigatinib; 90 mg/day Seems not superior

Note: a chi-square analysis of the ORR (not reported in the manuscript; our analysis) gives a non-significant ORR increase, 54% versus 45% (p=0.18).

Chemotherapy

  • Brigatinib (Alunbrig) as follows:
    • Lead-in: 90 mg PO once per day for 7 days
    • Subsequently: 180 mg PO once per day

Continued indefinitely

References

  1. ALTA: Kim DW, Tiseo M, Ahn MJ, Reckamp KL, Hansen KH, Kim SW, Huber RM, West HL, Groen HJM, Hochmair MJ, Leighl NB, Gettinger SN, Langer CJ, Paz-Ares Rodríguez LG, Smit EF, Kim ES, Reichmann W, Haluska FG, Kerstein D, Camidge DR. Brigatinib in patients with crizotinib-refractory anaplastic lymphoma kinase-positive non-small-cell lung cancer: a randomized, multicenter phase II trial. J Clin Oncol. 2017 Aug 1;35(22):2490-2498. Epub 2017 May 5. link to original article contains verified protocol PubMed
    1. Subgroup analysis: Camidge DR, Kim DW, Tiseo M, Langer CJ, Ahn MJ, Shaw AT, Huber RM, Hochmair MJ, Lee DH, Bazhenova LA, Gold KA, Ou SI, West HL, Reichmann W, Haney J, Clackson T, Kerstein D, Gettinger SN. Exploratory analysis of brigatinib activity in patients with anaplastic lymphoma kinase-positive non-small-cell lung cancer and brain metastases in two clinical trials. J Clin Oncol. 2018 Sep 10;36(26):2693-2701. Epub 2018 May 16. link to original article PubMed