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Crizotinib for First Line Treatment of ALK or ROS1 Rearrangements
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Dr. Ross Camidge, University of Colorado, explains the preference for crizotinib rather than platinum doublet chemotherapy as first line treatment for patients with ALK or ROS1 rearrangements.




Increasingly across many molecular subtypes of lung cancer, we’ve seen that giving a targeted drug first is better than going on chemotherapy. It doesn’t mean there’s no role for chemotherapy, but you’re going to start playing your best card first.

We’ve certainly seen within randomized studies that going on crizotinib compared to first line — what’s called platinum doublet, two drug chemotherapy — going on the targeted therapy was better. There was a higher response rate; there was a longer time before the cancer progressed.

For ROS-1, because it’s a much smaller population it’s hard to do those big randomized studies, but I think most people believe that, and I think that’s why ROS-1 probably should be in the panel of things that people look for from the get go to see if there’s a tablet that can treat your cancer more than just chemotherapy from the start.

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