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

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.