KEY TAKEAWAYS
- ALTA-1L trial (NCT02737501) phase 3 tested the efficacy of brigatinib vs crizotinib in ALK+ NSCLC among Asian and Non-Asian patients.
- The study’s primary objective was to evaluate the PFS demonstrated by brigatinib and crizotinib.
- 275 patients (108 Asian) were recruited in this sub-analysis. BIRC evaluated it.
- This study showed that brigatinib outperformed crizotinib regarding PFS for Asian and non-Asian patients.
Locally progressed or metastatic non-small cell lung cancer (NSCLC) in both crizotinib-resistant and ALK inhibitor-naive situations has been shown to respond well to brigatinib, a next-generation anaplastic lymphoma kinase (ALK) inhibitor. This study compared the efficacy of brigatinib between Asian and non-Asian patients in the ALTA-1L trial of first-line therapy.
This was a subanalysis of the phase III ALTA-1L trial comparing brigatinib to crizotinib in patients with ALK+ NSCLC who had never received an ALK inhibitor. The primary outcome was progression-free survival (PFS), measured by an independent review committee that was kept blind to the patients’ identities (BIRC). Both the overall objective response rate (ORR) and the progression-free survival (PFS) of patients with brain metastases were considered secondary objectives.
There were 275 patients in total, 108 of them were Asian. Results from the BIRC demonstrated that brigatinib consistently outperformed crizotinib in terms of progression-free survival (PFS) in both Asian and non-Asian patients (HR = 0.35 [95% CI = 0.20-0.59]; log-rank P =.0001; median 24.0 vs. 11.1 months). Both the investigator-assessed and BIRC-assessed intracranial PFS results were consistent. Brigatinib had a good safety profile. Both Asian and non-Asian individuals had similar toxicity profiles and rates of dosage modifications.
Across the board, brigatinib outperformed crizotinib in terms of effectiveness for patients of Asian and non-Asian descent with locally advanced or metastatic ALK-+ NSCLC who had not previously been treated with an ALK inhibitor. Overall, there were no significant variations in adverse events between Asian and non-Asian patients from a clinical standpoint.
Source: https://pubmed.ncbi.nlm.nih.gov/36038416/
Clinical trial: https://clinicaltrials.gov/ct2/show/NCT02737501
Ahn, M. J., Kim, H. R., Yang, J. C. H., Han, J. Y., Li, J. Y., Hochmair, M. J., Chang, G. C., Delmonte, A., Lee, K. H., Campelo, R. G., Gridelli, C., Spira, A. I., Califano, R., Griesinger, F., Ghosh, S., Felip, E., Kim, D. W., Liu, Y., Zhang, P., Popat, S., … Camidge, D. R. (2022). Efficacy and Safety of Brigatinib Compared With Crizotinib in Asian vs. Non-Asian Patients With Locally Advanced or Metastatic ALK-Inhibitor-Naive ALK+ Non-Small Cell Lung Cancer: Final Results From the Phase III ALTA-1L Study. Clinical lung cancer, 23(8), 720–730. https://doi.org/10.1016/j.cllc.2022.07.008
