The use of brigatinib in the treatment of ALK-positive NSCLC in the progression of crizotinib

Background

Brigatinib is a second-generation ALK tyrosine kinase inhibitor. The drug is currently FDA approved and recommended for the treatment of patients with ALK-positive non-small cell lung cancer after progression to crizotinib and another ALK inhibitor. The use of the drug in Russia is currently possible only within the framework of clinical trials or an expanded access program. This article contains the results of treatment of patients with ALK-positive NSCLC, in whom progression was detected while taking crizotinib, treated with brigatinib at the N.N. Blokhin

Objective
To analyze the median overall survival, including depending on the presence of metastases in the brain, overall and
intracranial response to brigatinib therapy, and tolerability of brigatinib therapy in patients with ALK-positive non-small
cell lung cancer previously treated with crizotinib and one or more lines of cytostatic therapy.
Materials and Methods
The study included 15 patients aged 33 to 70 years with a diagnosis of non-small cell lung cancer. All patients received
targeted therapy with crizotinib prior to initiation of brigatinib therapy. All patients received brigatinib 90 mg for the first
7 days, followed by dose increase to 180 mg daily until disease progression or intolerable toxicity.
Results
During the observation period at the time of February 2022, an objective response was achieved in 3 patients (20%),
in 11 patients (73.3%) – stabilization of the disease, in one patient – progression. The median duration of taking the drug
was just over 20.28 months. The drug intake was characterized by a predictable and manageable toxicity profile.
Conclusions
The data obtained indicate the immediate efficacy of brigatinib in patients with ALK translocations. The data obtained
do not contradict the results obtained in the course of clinical studies.