Dr. Shaw on Crizotinib as a Standard of Care in NSCLC

Alice T. Shaw, MD, PhD, an attending physician in the Center for Thoracic Cancers at Massachusetts General Hospital, discusses how crizotinib has changed patient care over the last few years.

Shaw says crizotinib, an FDA approved agent, is viewed as standard therapy for patients with ALK-positive lung cancer. Crizotinib received FDA approval based on single-arm studies, but there is now data from a randomized phase III study comparing the drug with standard single-agent chemotherapy (pemetrexed or docetaxel). Shaw says the study showed that crizotinib is superior to chemotherapy in the second-line setting in terms of extending PFS and improving response rates and quality of life.

The National Comprehensive Cancer Network (NCCN) recommends that all patients with advanced non-squamous lung cancer be tested for EGFR and ALK mutations. The NCCN also recommends front-line treatment of ALK-positive patients with crizotinib. However, this recommendation is not based on much data.

A trial has recently completed accrual that will evaluate first-line crizotinib versus platinum pemetrexed. Even though the results will not be available until the middle of 2014, it is still recommended that crizotinib be used as a standard agent even as a first-line agent in ALK-positive patients.