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Treatment of ALK-rearranged non-small-cell lung cancer with brigatinib as second or later lines

real-world observations from a single institution

Hochmair, Maximiliana; Weinlinger, Christopha; Schwab, Sophiaa; Naber, Jakobb; Setinek, Ulrikec; Krenbek, Dagmarc; Urban, Matthias H.a; Fabikan, Hannaha; Watzka, Stefanb; Koger, Renatea; Fazekas, Andreasa; Bitterlich, Erwind; Valipour, Arschanga; Burghuber, Otto C.a

doi: 10.1097/CAD.0000000000000787
Clinical Reports
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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.

aDepartment of Respiratory and Critical Care Medicine, Ludwig Boltzmann Institute of COPD and Respiratory Epidemiology

bDepartment of Thoracic Surgery, Otto Wagner Hospital

cInstitute of Pathology and Clinical Microbiology, Wilhelminenspital, Vienna

dDepartment of Pulmonology, Salzkammergut-Klinikum, Vocklabruck, Austria

Received 18 October 2018 Revised form accepted 10 March 2019

Correspondence to Maximilian Hochmair, MD, Respiratory Oncology Unit, Department of Respiratory and Critical Care Medicine, Otto-Wagner-Spital, Sanatoriumstrasse 2, 1140 Vienna, Austria Tel: +43 191 0604 1240; fax: +43 191 0604 1249; e-mail: maximilian.hochmair@wienkav.at

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