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Brigatinib: Novel ALK Inhibitor for Non-Small-Cell Lung Cancer.

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Published:1st Jun 2019
Author: Spencer SA, Riley AC, Matthew A, Di Pasqua AJ.
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Ref.:Ann Pharmacother. 2019;53(6):621-626.
DOI:10.1177/1060028018824578
Brigatinib: Novel ALK Inhibitor for Non-Small-Cell Lung Cancer


Objective:
We review here the pharmacology, pharmacokinetics, efficacy, safety, dosage and administration, potential drug-drug interactions and place in therapy of brigatinib for abnormal anaplastic lymphoma kinase (ALK) specific non-small-cell lung cancer (NSCLC).

Data sources: A literature search using PubMed was conducted using the terms brigatinib and ALK positive NSCLC from January 2013 to November 2018.

Study selection and data extraction: All English-language articles evaluating brigatinib were analyzed for this review.

Data synthesis: Brigatinib was granted approval for the treatment of patients with metastatic ALK+ NSCLC who have progressed on or are intolerant to crizotinib. It is administered at a dose of 90 mg orally once daily for the first 7 days then, if tolerated, increased to a dose of 180 mg orally once daily. Common adverse effects include nausea, fatigue, diarrhea, increased creatine phosphokinase levels, headache, dyspnea, and hypertension. Serious treatment-emergent adverse effects were pulmonary related. Relevance to Patient Care and Clinical Practice: This article discusses the clinical trials that led to the accelerated approval of brigatinib for its ability to overcome crizotinib-resistant mutations and for its increased central nervous system penetration properties.

Conclusion: Brigatinib was granted accelerated approval for the treatment of patients with metastatic ALK+ NSCLC who have progressed on or are intolerant to crizotinib. In a subset of NSCLC patients, brigatinib increases survival for approximately 1 year; however, side effects were detected.


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