Alectinib

(Alecensa®)

Alectinib

Drug updated on 4/18/2024

Dosage FormCapsule (oral; 150 mg)
Drug ClassKinase inhibitors
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the treatment of patients with anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC) as detected by an FDA-approved test.

Summary
This AI-generated content is provided without warranty and may be inaccurate or outdated; it should be used only as a research starting point, with no liability accepted for reliance on it. Learn more.

  • Alectinib (Alecensa) is indicated for the treatment of patients with anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC), demonstrating high efficacy in first- and second-line treatment settings. It has shown a significant advantage in prolonging overall survival and progression-free survival compared to chemotherapy and crizotinib.
  • The information was derived from 43 studies comparing the safety and effectiveness of alectinib with other ALK inhibitors such as crizotinib, ceritinib, brigatinib, ensartinib, and lorlatinib.
  • In terms of comparative effectiveness, alectinib outperforms crizotinib and other first-generation ALK inhibitors by preventing disease progression more effectively. However, it closely follows lorlatinib in efficacy outcomes globally but offers a better safety profile.
  • A key benefit of using alectinib is its superior performance against central nervous system metastases, which are common among ALK-positive NSCLC patients. This makes it more effective than both chemotherapy and crizotinib treatments.
  • Safety-wise, alectinib stands out due to its lower incidence rate for high-grade adverse events when compared to drugs like ceritinib, brigatinib, and lorlatinib, making it more tolerable for long-term use while maintaining quality of life standards for patients.
  • Alectinib's most common side effects include fatigue, constipation, and peripheral edema. However, these are milder than those associated with alternative treatments, thus affirming its higher tolerance levels amongst users.
  • In Asian patient populations specifically, alectinib significantly improved progression-free survival over any other available treatments, hence becoming the preferable choice as a first-line option within this demographic subgroup.
  • Patients suffering from CNS metastases also showed marked improvement under alectinib's administration, highlighting the drug’s efficiency even within difficult-to-treat population groups, potentially setting new standard management practices across such cases.

Product Monograph / Prescribing Information

Document TitleYearSource
Alecensa (alectinib) Prescribing Information.2021Genentech USA Inc., South San Francisco, CA

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Identifying optimal ALK inhibitors in first- and second-line treatment of patients with advanced ALK-positive non-small-cell lung cancer: a systematic review and network meta-analysis.2024BMC Cancer
Efficacy and safety of anaplastic lymphoma kinase inhibitors for non–small cell lung cancer: a systematic review and network meta-analysis.2023Thoracic Cancer
Comparative efficacy of ALK inhibitors for treatment-naïve ALK-positive advanced non-small cell lung cancer with central nervous system metastasis: a network meta-analysis.2023Cancer
Alectinib for treating patients with metastatic ALK-positive NSCLC: systematic review and network metanalysis.2023Lung Cancer Management
Comparing efficacy and safety of upfront treatment strategies for anaplastic lymphoma kinase-positive non-small cell lung cancer: a network meta-analysis.2023Exploration of Targeted Anti-Tumor Therapy
Comparative safety of anaplastic lymphoma kinase tyrosine kinase inhibitors in advanced anaplastic lymphoma kinase-mutated non-small cell lung cancer: systematic review and network meta-analysis.2023Lung Cancer
A Bayesian network meta-analysis of ALK inhibitor treatments in patients with ALK-positive non-small cell lung cancer.2023Cancer Medicine
Safety and efficacy of alectinib versus crizotinib in alk-positive non-small cell lung cancer: an update meta-analysis.2023Pakistan Journal of Pharmaceutical Sciences
Efficacy and safety of anaplastic lymphoma kinase inhibitors for non-small cell lung cancer: a systematic review and network meta-analysis.2023Thoracic Cancer
Targeted therapy for advanced anaplastic lymphoma kinase (ALK)‐rearranged non‐small cell lung cancer.2022Cochrane Database of Systematic Reviews
A systematic review of companion diagnostic tests by immunohistochemistry for the screening of alectinib-treated patients in ALK-positive non-small cell lung cancer. 2022Diagnostics
Toxicity profile of anaplastic lymphoma kinase tyrosine kinase inhibitors for patients with non small cell lung cancer: a systematic review and meta analysis. 2022Investigational New Drugs
First-line treatments for patients with advanced ALK gene rearrangements in NSCLC: a systematic review and network meta-analysis.2022Journal of International Medical Research
Indirect comparisons of brigatinib and alectinib for front-line ALK-positive non-small-cell lung cancer.2022Future Oncology
Front-line treatment for advanced non-small-cell lung cancer and ALK fusion: a network meta-analysis.2022Journal of Clinical Medicine
Crizotinib versus alectinib for the treatment of ALK-positive non-small cell lung cancer: a systematic review and meta-analysis.2022Chemotherapy
Overall survival indirect treatment comparison between brigatinib and alectinib for the treatment of front-line anaplastic lymphoma kinase-positive non-small cell lung cancer using data from ALEX and final results from ALTA-1L.2022Current Medical Research and Opinion
ALK inhibitors in ALK-rearranged non-small cell lung cancer with and without brain metastases: systematic review and network meta-analysis.2022BMJ Open
Comparison of efficacy and safety of brigatinib in first-line treatments for patients with anaplastic lymphoma kinase-positive non-small-cell lung cancer: a systematic review and indirect treatment comparison.2022Journal of Clinical Medicine
First-line anaplastic lymphoma kinase (ALK) inhibitors for ALK-positive lung cancer in Asian populations: systematic review and network meta-analysis. 2021Journal of Clinical Medicine
Comparative efficacy and safety of first-line treatments for advanced non-small cell lung cancer with ALK-rearranged: a meta-analysis of clinical trials. 2021BMC Cancer
Crizotinib versus alectinib for the treatment of ALK-positive non-small cell lung cancer: a systematic review and meta-analysis.2021Chemotherapy
Systematic review and network meta-analysis of anaplastic lymphoma kinase (ALK) inhibitors for treatment-naïve ALK-positive lung cancer. 2021Cancers
Comparison of lorlatinib, alectinib and brigatinib in ALK inhibitor–naive/untreated ALK-positive advanced non-small-cell lung cancer: a systematic review and network meta-analysis.2021Journal of Chemotherapy
Comparative efficacy and safety of lorlatinib and alectinib for ALK-rearrangement positive advanced non-small cell lung cancer in Asian and non-Asian patients: a systematic review and network meta-analysis.2021Cancers
Comparison of clinical efficacy of alectinib versus crizotinib in ALK-positive non-small cell lung cancer: a meta-analysis. 2021Frontiers in Oncology
ALK inhibitor-induced bradycardia: a systematic-review and meta-analysis.2021Lung Cancer
A Bayesian network meta-analysis regarding the comparative efficacy of therapeutics for ALK-positive, brain metastatic non-small cell lung cancer.2021Pharmacological Research
Comparison of clinical efficacy of alectinib versus crizotinib in ALK-positive non-small cell lung cancer: a meta-analysis.2021Frontiers in Oncology
Efficacy and safety of first-line treatment strategies for anaplastic lymphoma kinase-positive non-small cell lung cancer: a Bayesian network meta-analysis.2021Frontiers in Oncology
Comparative efficacy of systemic agents for brain metastases from non-small-cell lung cancer with an EGFR mutation/ALK rearrangement: a systematic review and network meta-analysis.2021Frontiers in Oncology
Brigatinib and alectinib for ALK rearrangement-positive advanced non-small cell lung cancer with or without central nervous system metastasis: a systematic review and network meta-analysis.2020Cancers
ALK inhibitors for non-small cell lung cancer: a systematic review and network meta-analysis.2020PLoS One
Effect of alectinib versus crizotinib on progression-free survival, central nervous system efficacy and adverse events in ALK-positive non-small cell lung cancer: a systematic review and meta-analysis.2020Annals of Palliative Medicine
Cost effectiveness of ceritinib and alectinib versus crizotinib in first-line anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer.2020Clinical Drug Investigation
Comparative efficacy of targeted therapies in patients with non-small cell lung cancer: a network meta-analysis of clinical trials.2020Journal of Clinical Medicine
Pooled overall survival and safety data from the pivotal phase II studies (NP28673 and NP28761) of alectinib in ALK-positive non-small-cell lung cancer.2020Lung Cancer
Efficacy of crizotinib, ceritinib, and alectinib in ALK-positive non-small cell lung cancer treatment: a meta-analysis of clinical trials. 2020Cancers
Effect of alectinib versus crizotinib on progression-free survival, central nervous system efficacy and adverse events in ALK-positive non-small cell lung cancer: a systematic review and meta-analysis2020Annals of Palliative Medicine
Meta-analysis of overall incidence and risk of ALK inhibitors-induced liver toxicities in advanced non-small-cell lung cancer.2019Medicine (Baltimore)
ALK inhibitors in the treatment of ALK positive NSCLC.2019Frontiers in Oncology
Safety issues with the ALK inhibitors in the treatment of NSCLC: a systematic review.2019Critical Reviews in Oncology/Hematology
The safety and serious adverse events of approved ALK inhibitors in malignancies: a meta-analysis.2019Cancer Management and Research
The incidence of ALK inhibitor-related pneumonitis in advanced non-small-cell lung cancer patients: a systematic review and meta-analysis.2019Lung Cancer
Anaplastic lymphoma kinase inhibitors in non-small cell lung cancer patients with brain metastases: a meta-analysis.2019Journal of Thoracic Disease

Clinical Practice Guidelines