The J-ALEX trial—is frontline alectinib a new standard of care?

Jeffrey Zweig,, Heather A. Wakelee


In patients with metastatic anaplastic lymphoma kinase (ALK) positive non-small-cell lung cancer (NSCLC), the options for therapy in both the first and second line setting are becoming increasingly complex. In the United States, both crizotinib and ceritinib are Food and Drug Administration (FDA) approved for use in the upfront setting, with ceritinib, alectinib, and most recently brigatinib, all having received FDA approval in the second line setting after progression of disease on crizotinib (1). Several other ALK tyrosine kinase inhibitors (TKIs) are under investigation, with lorlatinib having recently received breakthrough FDA designation as a second line treatment and ensartinib also showing significant efficacy in ALK TKI pre-treated patients (2,3).

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