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ALTA-1L showed that brigatinib more than doubled the time ALK-positive lung cancer stayed under control compared with crizotinib, with strong activity against brain metastases.
ALTA-1L randomised 275 patients with untreated advanced ALK-positive non-small-cell lung cancer to brigatinib or crizotinib, allowing up to one prior line of chemotherapy. Brigatinib had been approved in 2017 for patients who had progressed on crizotinib.
In the final analysis median progression-free survival by blinded independent review was 24.0 months with brigatinib against 11.1 months with crizotinib (hazard ratio 0.48); among patients with brain metastases at baseline the intracranial response rate was much higher with brigatinib. Early pulmonary events in the first week, seen in a small minority, are the drug's distinctive toxicity and are managed by a lower starting dose.
The FDA approved brigatinib for first-line use in May 2020, giving a third first-line option alongside alectinib and lorlatinib.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
275 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Progression-free survival (blinded independent review, final)primary | Brigatinib | 137 | 24 months | 0.48 | - | link |
| Crizotinib | 138 | 11.1 months |
One trial page on OnCo cites this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing page listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
This is the paper Europe PMC returns for registry id NCT02737501 with the most citations, so it is the natural first reading for anyone following the ALTA-1L trial. Read the abstract above alongside the trial page and the registry entry; the record was linked automatically and its figures have not been checked by hand.
Shares ALTA, D. Ross Camidge, Brigatinib, Takeda.
Shares D. Ross Camidge, eXalt3, ASCEND-4, PROFILE 1014.
Shares D. Ross Camidge, eXalt3, ASCEND-4, PROFILE 1014.
Shares PROFILE 1014, Crizotinib, Brain metastases (intracranial disease), ALK-positive non-small-cell lung cancer.
Shares PROFILE 1014, Crizotinib, Brain metastases (intracranial disease), ALK-positive non-small-cell lung cancer.
Shares D. Ross Camidge, Crizotinib, Brain metastases (intracranial disease), ALK-positive non-small-cell lung cancer.
Shares ASCEND-4, ALK-positive non-small-cell lung cancer, ALK, Lung cancer (all types).
Shares Crizotinib, Brain metastases (intracranial disease), ALK-positive non-small-cell lung cancer, ALK.