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Anticancer Drugs. 2019 Aug;30(7):e0787. doi: 10.1097/CAD.0000000000000787.

Treatment of ALK-rearranged non-small-cell lung cancer with brigatinib as second or later lines: real-world observations from a single institution.

Author information

1
Department of Respiratory and Critical Care Medicine, Ludwig Boltzmann Institute of COPD and Respiratory Epidemiology.
2
Department of Thoracic Surgery, Otto Wagner Hospital.
3
Institute of Pathology and Clinical Microbiology, Wilhelminenspital, Vienna.
4
Department of Pulmonology, Salzkammergut-Klinikum, Vocklabruck, Austria.

Abstract

The second-generation ALK tyrosine kinase inhibitor brigatinib has recently been approved in the European Union for use after crizotinib treatment in patients with EML4-ALK-rearranged lung cancer. In the current study, brigatinib was investigated as second-line or later-line treatment in 35 patients who had developed resistance to crizotinib, ceritinib, or alectinib. Most patients (68.6%) received brigatinib as second or third line (range: second to 12th line). In the total cohort, complete and partial responses were obtained for 9.1 and 75.8%, respectively. Overall median progression-free survival was 9.9 months, whereas the largest treatment cohort (brigatinib after crizotinib failure) showed a median progression-free survival of 8.4 months. Fifty-four percent of patients with baseline brain metastases responded to brigatinib treatment. Brigatinib was highly effective after crizotinib and ceritinib failure. Six patients had received alectinib as monotherapy, second-line, or third line before brigatinib; of these, four experienced partial responses and two progressed responses. Brigatinib treatment was well tolerated.

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