Brig deal.

The preferred first-line treatment for advanced, ALK-rearranged NSCLC is alectinib with brigatinib and ceritinib coming in close behind. In an effort to improve its first-line appeal, we have results from the second interim analysis of the ALTA-1L trial. As a reminder, this trial compared brigatinib with the old standard crizotinib as first-line therapy. It showed a significant improvement in progression-free survival on interim analysis. This “second interim analysis” means there have been more events (150 or 75% of final analysis events) and longer followup. It confirms the superiority of brigatinib with a median PFS of 24 months compared to 11 for crizotinib. In contrast to the ALEX trial (alectinib), patients in ALTA-L1 were allowed to cross-over at progression which the authors offer as a reason why there was no significant difference in OS between arms. TBL: Brigatinib remains a solid first-line treatment option for patients with advanced, ALK-rearranged NSCLC. | Camidge, J Clin Oncol 2020