Posted: 1 May 2024
A clinical trial led by a Peter Mac medical oncologist has demonstrated the benefits of a new lung cancer treatment, and these practise-changing results have just published in the New England Journal of Medicine.
Patients in the ALINA trial had early-stage ALK-positive non-small cell lung cancer (NSCLC) – which accounts for about 5% of all lung cancers and is most common in patients who have never or rarely smoked.
All 257 patients in the trial had surgery to remove their lung cancer, and then they received follow-up treatment with either conventional chemotherapy or the targeted therapy drug alectinib.
Treatment with alectinib reduced the risk of recurrence of the cancer after surgery compared to chemotherapy. In the alectinib group, 93.8% of patients were alive and had no sign of their lung cancer two years later, compared to 63.0% in the chemotherapy group. At three years post-treatment, the difference was 88.3% versus 53.3%.
The trial was led by Peter Mac’s Professor Ben Solomon who says this rare cancer has a high recurrence rate, and this often can spread to the brain.
“The great hope, in terms of improving outcomes for these patients, has been the arrival of a targeted drug that works well against this cancer and reduces the chance of the cancer returning after surgery” Prof Solomon says.
“In the ALINA trial, patients treated with alectinib after surgery had significantly improved disease-free survival compared to those who received conventional chemotherapy.
“Importantly, we also saw a benefit in terms of fewer brain metastases in patients whose lung cancer did return.”
Just 15 patients (11.5%) in the alectinib group had their cancer return compared to 49 (38.6%) who received chemotherapy. Just four patients in the alectinib group had brain metastases, versus 14 who received chemotherapy.
Alectinib was also well tolerated with a low incidence of serious adverse events.
The data was revealed for the first time by Prof Solomon in a Presidential Symposium at the European Society of Medical Oncology Congress (ESMO), in late October 2023. Alectinib was approved for this indication on the 18th April 2024 by the US FDA.
Read the paper in full: Alectinib in Resected ALK-Positive Non–Small-Cell Lung Cancer | New England Journal of Medicine (nejm.org)
