Analysis of the effectiveness of brigatinib in the treatment of lung cancer

Brigatinib (Brigatinib), as a targeted therapy for ALK -positive non-small cell lung cancer, has shown significant clinical effectiveness in clinical trials in recent years.

Brigatinib, also known as brigatinib, is a tyrosine kinase inhibitor(TKI) designed to specifically target and inhibit the ALK fusion protein. It achieves the purpose of inhibiting tumor growth by effectively inhibiting the activity of ALK. In numerous clinical trials, brigatinib has demonstrated significant efficacy in patients with ALK-positive non-small cell lung cancer.

In the pivotal ALTA-1L clinical trial, brigatinib was compared head-to-head with the first-generation ALK inhibitor crizotinib. This is an international multi-center, randomized controlled, open-label phase III study. Patients were randomly assigned to brigatinib or crizotinib. Patients in the brigatinib group first underwent a 7 days introduction period, taking 90mg daily, and then increased to 180mg daily; while patients in the crizotinib group took 250mg twice a day.

The study results show that compared with crizotinib, brigatinib shows superiority in many aspects. First, in terms of progression-free survival (PFS), patients in the brigatinib group showed longer PFS. Specifically, the median PFS in the brigatinib group has not yet been reached, while the median PFS in the crizotinib group was 9.8 months. In addition, the 1-year progression-free survival rate in the brigatinib group was 67%, which was significantly higher than the crizotinib group's 43%.

For patients with brain metastases at baseline, the efficacy of brigatinib is more significant. The objective response rate (ORR) of intracranial lesions reached 78% in the brigatinib group but only 29% in the crizotinib group. At the same time, brigatinib also reduced the risk of intracranial disease progression by 73% in patients with brain metastases.

In terms of safety, brigatinib also showed good tolerability. Although the incidence of some adverse reactions in the brigatinib group was higher than that in the crizotinib group, such as gastrointestinal symptoms, increased creatine kinase levels, etc., most of these reactions were controllable and well tolerated by patients. It is worth noting that the incidence of interstitial lung disease or pneumonia in the brigatinib group was slightly higher than that in the crizotinib group, which requires clinicians to pay close attention during medication.

The data of brigatinib in the treatment of brain metastases from lung cancer are very significant. In the ALTA-1L trial, for patients with baseline brain metastases, the objective response rate was as high as 78% in the brigatinib group, compared with 26% in the control group. In addition, for patients with intracranial lesions in remission, brigatinib had a sustained response time of 27.9 months, while the crizotinib group only had 9.2 months. These data fully demonstrate the superiority of brigatinib in the treatment of lung cancer brain metastases.

In summary, brigatinib has demonstrated significant clinical effectiveness in the treatment of lung cancer. It can be seen from the data of the ALTA-1L trial that brigatinib has shown significantly better results than crizotinib in terms of progression-free survival, objective response rate, and the treatment of patients with brain metastases. Therefore, brigatinib may serve as an effective treatment option for patients with ALKpositive non-small cell lung cancer. At the same time, clinicians also need to pay attention to possible adverse reactions when using brigatinib and take appropriate treatment measures to ensure patient safety.

References:

https://pmc.ncbi.nlm.nih.gov/articles/PMC9669367/