Brigatinib for treatment of anaplastic lymphoma kinase-rearranged metastatic non-small cell lung cancer

ABSTRACT

Introduction: Crizotinib has been approved as a first-line treatment for patients with anaplastic lymphoma kinase (ALK)-rearranged advanced non-small-cell lung cancer (NSCLC). However, the majority of patients treated with crizotinib experience progression within 1 year, and the central nervous system (CNS) is the most common site of progression. Brigatinib, a potent and selective ALK inhibitor that can inhibit multiple crizotinib-resistant ALK mutants, has shown superior efficacy in advanced ALK-rearranged NSCLC, including in patients with CNS metastases.

Areas covered: We reviewed the characteristics of brigatinib, and its clinical efficacy and safety have been demonstrated in previous pivotal studies.

Expert opinion: Brigatinb was recently approved for use in ALK-rearranged NSCLC with acquired resistance to crizotinib as first-line treatment. Moreover, brigatinib is highly active in patients with CNS metastasis. The major concern about pulmonary adverse events was resolved with changes in treatment schedule. The mechanisms of resistance to brigatinib and the sequence of treatment with other ALK inhibitors are unresolved issues.

KEYWORDS:

• ALK rearrangemen
• Brigatinib
• CNS metastases
• NSCLC

Acknowledgements

This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare (grant number; HI16C1984).

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, and royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose

Additional information

Funding

This research was supported by a grant from the Korean Health Technology R&D Project through the Korean Health Industry Development Institute, funded by the Ministry of Health and Welfare (grant number; HI16C1984).