Leena Gandhi, MD, PhD, director of the Thoracic Medical Oncology Program at NYU Langone School of Medicine, discusses the role of alectinib (Alecensa) in patients with 

-positive non—small cell lung cancer (NSCLC).

Gandhi says that there is clear-cut evidence of the superiority of alectinib over crizotinib (Xalkori). Results from the J-ALEX and ALEX trials showed improved long-term outcomes systemically with alectinib, and in the central nervous system (CNS), as well.

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Leena Gandhi, MD, PhD, director of the Thoracic Medical Oncology Program at NYU Langone School of Medicine, discusses the role of alectinib (Alecensa) in patients with ALK-positive non-small cell lung cancer (NSCLC).

Dr. Gandhi Discusses the Role of Alectinib in ALK+ Lung Cancer

Leena Gandhi, MD, PhD, associate professor, Department of Medicine, director, Thoracic Medical Oncology Program, discusses the findings of cohort G of the KEYNOTE-021 trial that explored the combination of pembrolizumab (Keytruda) with carboplatin and pemetrexed for patients with advanced nonsquamous non-small cell lung cancer (NSCLC).

KEYNOTE-021 was initially a phase I study with a phase II expansion phase, Gandhi explains. In the phase II portion, 123 patients were randomized 1:1 to receive pembrolizumab plus first-line chemotherapy and half of whom had carboplatin/pemetrexed alone. The study, which was presented in 2016, showed that there was a progression-free survival benefit in those who received the immunotherapy/combination approval. However, there was not a benefit seen for overall survival with this novel regimen.

Based on these data, the FDA approved the regimen of pembrolizumab and carboplatin/pemetrexed in the first-line setting for these patients. The field is eagerly awaiting the data from the phase III study, adds Gandhi.

Dr. Gandhi on Pembrolizumab/Chemo Findings in NSCLC and FDA Approval

Leena Gandhi, MD, PhD, director of the Thoracic Medical Oncology Program at NYU Langone School of Medicine, discusses sequencing challenges as well as emerging agents in the field of ALK-positive non—small cell lung cancer (NSCLC).

Sequencing is a very challenging topic in this field currently, because there are several ongoing trials that may establish a new first-line standard of care. For example, there is the J-ALEX trial of alectinib (Alecensa) versus crizotinib (Xalkori) that has been reported out of Japan; it’s still ongoing in the United States with the ALEX trial. Alectinib is now a standard of care for first-line therapy in Japan and Gandhi suspects that it will become so in the United States, as well.

This will lead to a dramatic shift in the second-line setting, and newer agents moving through the pipeline are likely to play an important role in that area, too.

Such drugs include brigatinib and lorlatinib, which hold promise not only as second-line treatment, but in the upfront setting, as well, Gandhi says.

Leena Gandhi, MD, PhD, director of the Thoracic Medical Oncology Program at NYU Langone School of Medicine, discusses sequencing challenges as well as emerging agents in the field of ALK-positive non–small cell lung cancer (NSCLC).


Leena Gandhi, MD, PhD

Articles

Dr. Gandhi Discusses the Role of Alectinib in ALK+ Lung Cancer

Dr. Gandhi on Pembrolizumab/Chemo Findings in NSCLC and FDA Approval

Dr. Gandhi on Sequencing and Emerging Agents in ALK+ NSCLC