Next-generation ALK inhibitors: is the median the message?
Mené sur 160 patients atteints d'un cancer du poumon non à petites cellules de stade IIIB ou IV ALK+, cet essai de phase II évalue l'efficacité, du point de vue de la proportion de patients obtenant une réponse objective, et la toxicité de l'ensartinib après l'échec du crizotinib
Oncogenic rearrangements of the ALK gene occur in approximately 4% of non-small-cell lung cancers (NSCLCs). The first-generation ALK inhibitor crizotinib was approved by the US Food and Drug Administration for treatment of advanced ALK-positive NSCLC in 2011. Since then, three next-generation ALK inhibitors—alectinib, ceritinib, and brigatinib—have been approved for use after crizotinib. Lorlatinib has been approved for use after any of these other next-generation inhibitors; alectinib and ceritinib have been approved as first-line treatment instead of crizotinib; and there is also some preliminary positive data for brigatinib in the first-line setting. Trials are also underway of two other next-generation inhibitors, lorlatinib (CROWN, NCT03052608) and ensartinib (eXalt3, NCT02767804), versus crizotinib for first-line treatment of ALK-positive NSCLC. In The Lancet Respiratory Medicine, Yunpeng Yang and colleagues provide phase 2 activity data for yet another ALK inhibitor, ensartinib, in the post-crizotinib setting. In the absence of direct head-to-head comparisons of this crowded field of next-generation drugs, how can these new data for ensartinib and, by extension, the potential usefulness of the drug be assessed?
The Lancet Respiratory Medicine , commentaire, 2018