One of the major innovations in the field of lung cancer over the past decade has been the discovery of ALK gene rearrangements and the development of targeted drugs for ALK rearrangement (ALK tyrosine kinase inhibition). Today, I will talk about new progress in the targeted treatment of ALK gene rearrangement lung cancer.
Recently, a new study published by the world's top journal The Lancet official website has shown that for the detection of advanced non-small cell lung cancer (NSCLC) with ALK rearrangement, the initial (first-line) use of Novartis-targeted drug Zykadia ( Ceritinib, ceritinib) prolonged progression-free survival (PFS) by a factor of 2 compared to chemotherapy.
ALK gene rearrangement is an important molecule driving lung cancer, and about 3-7% of non-small cell lung cancer is associated with ALK gene rearrangement. There are precedents for ALK targeted drugs to overcome chemotherapy. Pfizer's first-generation ALK targeting drug, crizotinib, was first demonstrated to be superior to chemotherapy in the first-line, and became the first-line treatment for ALK rearrangement of non-small cell lung cancer. However, the vast majority of patients receiving crizotinib will eventually develop drug resistance, usually in the treatment of disease progression around 11 months, the progress of the site is more common in the central nervous system.
The development of a new generation of ALK targeted drugs has worked hard to overcome crizotinib-resistant mutations and penetrate blood-brain barrier permeability (in order to increase the concentration and effect of drugs in the central nervous system). Moreover, clinical data have shown that a new generation of ALK-targeted drugs such as ceritinib, alectinib and brigitinib have shown significant efficacy in both crizotinib-resistant patients and patients who have not used crizotinib. The sequential treatment of ceritinib or alectinib with crizotinib has also been shown to provide long-term disease control, allowing patients to achieve good survival.
This newly released clinical phase 3 randomized controlled trial, code-named ASCEND-4, has new breakthroughs, demonstrating that certinib's first-line treatment model also outperforms chemotherapy, which may update and enrich the existing ALK. A targeted treatment model for the rearrangement of advanced lung cancer. The following describes the ASCEND-4 data published online under the Lancet official website.
The researchers recruited 376 previously untreated patients with advanced non-small cell lung cancer who were detected with ALK rearrangement at 134 centers in 28 countries around the world, and were randomized into experimental and control groups at a 1:1 ratio. The experimental group received first-line treatment with ceritinib, and the control group received first-line and maintenance chemotherapy (platinum-based drugs combined with pemetrexed for two cycles of chemotherapy with pemetrexed). The results of the study showed that the median progression-free survival of the experimental group was 16.6 months, and the median progression-free survival of the control group was 8.1 months, which was 2 times longer; the effective rate was nearly 3 times (72. 5% vs. 26.7%).
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