P84.05 Efficacy and Safety of Ceritinib 450-mg Fed vs 750-mg Fasted in Patients with ALK+ NSCLC: Final Report of the ASCEND-8 Trial

Cho, B.C.; Kim, D.; Laurie, Scott A.; McKeage, Mark J.; Borra, Gloria; Park, K.; Kim, S.; Ghosn, Marwan; Ardizzoni, Andrea; Greystoke, Alastair; Izquierdo, M.; Wang, Y.; Wang, L.; Wrona, Anna

doi:10.1016/j.jtho.2021.01.1204

Cited by 2 publications

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“…Notably, patients receiving ceritinib experienced the highest incidence of vomiting, nausea, and vision disorder, consistent with its high frequency of gastrointestinal toxicity reported previously. 7 Recently, the ASCEND-8 trial 40 demonstrated that ceritinib 450 mg/day with food gained comparable efficacy and effectively reduced the incidence of gastrointestinal AEs when compared with ceritinib 750 mg/day in the fasted state, providing a mitigation strategy for clinical utilization of ceritinib.…”

Section: Discussionmentioning

confidence: 99%

Front-line treatment for advanced non-small-cell lung cancer and ALK fusion: a network meta-analysis

et al. 2022

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Background: It remains unknown what is the optimal front-line choice for advanced non-small-cell lung cancer (NSCLC) with anaplastic lymphoma kinase (ALK) fusion. Methods: We conducted a systematic review and network meta-analysis of randomized phase III clinical trials comparing two or more treatments as the front-line setting for patients with advanced ALK-positive NSCLC. Results: Nine phase III randomized clinical trials with 2367 patients were included. As to efficacy, lorlatinib had the most favorable progression-free survival [PFS; surface under the cumulative ranking curve (SUCRA) = 98.4%] in the first-line setting, with noticeable outcome benefits versus chemotherapy [hazard ratio (HR): 0.12; 95% confidence interval (CI): 0.08–0.19], crizotinib (HR: 0.28; 95% CI: 0.19–0.41), ceritinib (HR: 0.22; 95% CI: 0.13–0.37), and brigatinib (HR: 0.58; 95% CI: 0.35–0.96), as well as beneficial trends when compared with alectinib (HR: 0.66; 95% CI: 0.41–1.04) and ensartinib (HR: 0.62; 95% CI: 0.36–1.08). Meanwhile, alectinib showed the optimal overall survival (OS; SUCRA = 91.2%), with significant improvements over chemotherapy (HR: 0.47; 95% CI: 0.30–0.72) and crizotinib (HR: 0.58; 95% CI: 0.41–0.82). Similarly, brigatinib also displayed prolonged OS compared with crizotinib after adjustment for crossover by the marginal structural model (HR: 0.54; 95% CI: 0.31–0.92). In terms of safety, alectinib had the fewest grade 3–5 adverse events (SUCRA = 98.9%), with marked advantages versus crizotinib [odds ratio (OR): 0.67; 95% CI: 0.46–0.97], ceritinib (OR: 0.21; 95% CI: 0.10–0.43), brigatinib (OR: 0.37; 95% CI: 0.20–0.69), ensartinib (OR: 0.48; 95% CI: 0.27–0.89), and lorlatinib (OR: 0.30; 95% CI: 0.16–0.54). Conclusions: Lorlatinib may have advantageous PFS compared with other agents but a greater risk of severe toxicity. Second-generation inhibitors, including alectinib, brigatinib, and ensartinib, provide major efficacy with less toxicity and remain appropriate regimens in the front-line setting.

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Section: Discussionmentioning

confidence: 99%