Transcript
Announcer:
This is Project Oncology on ReachMD. On this episode, Dr. Jorge Nieva, an Associate Professor of Clinical Medicine at Keck Medicine of USC, will discuss the evolving treatment landscape for ALK-positive non-small cell lung cancer. Let’s hear from him now.
Dr. Nieva:
ALK lung cancer makes up roughly two percent of lung cancers in the United States. These tend to be younger patients, and these are patients who are more commonly female. And we've really established that tyrosine kinase inhibitor therapy is superior to chemotherapy, and I don't think there's anybody around in the country who is using chemotherapy as the initial therapy for these patients.
There are a number of generations of ALK inhibitors available, starting with crizotinib. Then we have second-generation inhibitors such as alectinib, brigatinib, and sartinib. More recently, we have third-generation inhibitors approved, such as lorlatinib. And we're anxiously expecting the approval of a fourth-generation inhibitor soon.
The first-generation inhibitor crizotinib has been around for more than a decade, and I think it has clearly been demonstrated to be inferior to the other ALK inhibitors. Every trial that has been randomized against crizotinib has shown the newer generation inhibitors to be superior. We've looked at this in real-world data as well, where we looked at things like survival characteristics for patients treated with crizotinib versus those who were treated with newer generations of ALK inhibitors, and we found that survival really is better with the newer agents.
Most clinical trials have really focused on progression-free survival as the primary endpoint. Response rates, of course, have been looked at as well. There really is not a lot of data showing superiority from the standpoint of overall survival, and that's not really unexpected. These patients live a very long time now and oftentimes can switch from one drug to another. So seeing an overall survival difference is actually quite difficult in randomized clinical trials. A lot of follow-up is required.
Announcer:
That was Dr. Jorge Nieva discussing treatment options for ALK-positive non-small cell lung cancer. To access this and other episodes in this series, visit Project Oncology on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
