New FDA Approval for Zykadia (ceritinib) for ALK-Positive NSCLC: Why I Think It's a Poor Choice for Initial Treatment

Article

The FDA just approved a new therapy for the approximately 4% of patients with NSCLC who have the molecular marker known as an ALK rearrangement. The agent Zykadia (ceritinib), a "second generation" ALK inhibitor that is more effective than Xalkori (crizotinib) in lab models of ALK-positive NSCLC, and the new approval was for Zykadia as first line treatment for ALK-positive lung cancer, a setting where we have historically favored Xalkori since it was approved in 2011. .

4 plus years stage 4 NSCLC with ALK mutation

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New and first time post. Wife diagnosed nsclc 7/2012 stage 4 ALK mutation. Now 57 never smoker and active exerciser. Full 6 treatments carbo/alimta and 1plus year alimta maintenance. Crizotinib about a year forced to ceritinib due to more than 25 brain mets and balnce issues. also at same time, whole brain radiation in 10/2015 mistake??? Brain mets size reduced and stable as of 6/2016. Was it radiation or ceritinib?? Bone mets in shoulder 2/2016 and palliative rad.

Should Alecensa (Alectinib) be the new first line ALK inhibitor for ALK-positive NSCLC?

Article

Probably the most immediate potentially practice-changing presentation from ASCO was the Japanese J-ALEX study in the subset of about 4-5% of patients with non-small cell lung cancer (NSCLC) who have the molecular driver known as an anaplastic lymphoma kinase (ALK) rearrangement, which we now routinely test for from the tumor tissue of patients with a non-squamous metastatic NSCLC.