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dc.contributor.authorCamidge, DR
dc.contributor.authorKim, HR
dc.contributor.authorAhn, M-J
dc.contributor.authorYang, JCH
dc.contributor.authorHan, J-Y
dc.contributor.authorHochmair, MJ
dc.contributor.authorLee, KH
dc.contributor.authorDelmonte, A
dc.contributor.authorGarcia Campelo, MR
dc.contributor.authorKim, D-W
dc.contributor.authorGriesinger, F
dc.contributor.authorFelip, E
dc.contributor.authorCalifano, R
dc.contributor.authorSpira, AI
dc.contributor.authorGettinger, SN
dc.contributor.authorTiseo, M
dc.contributor.authorLin, HM
dc.contributor.authorLiu, Y
dc.contributor.authorVranceanu, F
dc.contributor.authorNiu, H
dc.contributor.authorZhang, P
dc.contributor.authorPopat, S
dc.date.accessioned2021-12-07T14:59:33Z
dc.date.available2021-12-07T14:59:33Z
dc.date.issued2021-09-16
dc.identifier.citationJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2021
dc.identifier.issn1556-0864
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/4916
dc.identifier.eissn1556-1380
dc.identifier.doi10.1016/j.jtho.2021.07.035
dc.description.abstractIntroduction In the phase 3 study entitled ALK in Lung cancer Trial of brigAtinib in 1st Line (ALTA-1L), which is a study of brigatinib in ALK inhibitor-naive advanced ALK-positive NSCLC, brigatinib exhibited superior progression-free survival (PFS) versus crizotinib in the two planned interim analyses. Here, we report the final efficacy, safety, and exploratory results. Methods Patients were randomized to brigatinib 180 mg once daily (7-d lead-in at 90 mg once daily) or crizotinib 250 mg twice daily. The primary end point was a blinded independent review committee-assessed PFS. Genetic alterations in plasma cell-free DNA were assessed in relation to clinical efficacy. Results A total of 275 patients were enrolled (brigatinib, n = 137; crizotinib, n = 138). At study end, (brigatinib median follow-up = 40.4 mo), the 3-year PFS by blinded independent review committee was 43% (brigatinib) versus 19% (crizotinib; median = 24.0 versus 11.1 mo, hazard ratio [HR] = 0.48, 95% confidence interval [CI]: 0.35-0.66). The median overall survival was not reached in either group (HR = 0.81, 95% CI: 0.53-1.22). Posthoc analyses suggested an overall survival benefit for brigatinib in patients with baseline brain metastases (HR = 0.43, 95% CI: 0.21-0.89). Detectable baseline EML4-ALK fusion variant 3 and TP53 mutation in plasma were associated with poor PFS. Brigatinib exhibited superior efficacy compared with crizotinib regardless of EML4-ALK variant and TP53 mutation. Emerging secondary ALK mutations were rare in patients progressing on brigatinib. No new safety signals were observed. Conclusions In the ALTA-1L final analysis, with longer follow-up, brigatinib continued to exhibit superior efficacy and tolerability versus crizotinib in patients with or without poor prognostic biomarkers. The suggested survival benefit with brigatinib in patients with brain metastases warrants future study.
dc.formatPrint-Electronic
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleBrigatinib Versus Crizotinib in ALK Inhibitor-Naive Advanced ALK-Positive NSCLC: Final Results of Phase 3 ALTA-1L Trial.
dc.typeJournal Article
dcterms.dateAccepted2021-07-30
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1016/j.jtho.2021.07.035
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.licenseref.startdate2021-09-16
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Thoracic Oncology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Thoracic Oncology/Thoracic Oncology (hon.)
pubs.publication-statusPublished
pubs.embargo.termsNot known
icr.researchteamThoracic Oncology
dc.contributor.icrauthorPopat, Sanjayen_US


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