Expert Point of View: John V. Heymach, MD, PhD

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“This is a watershed moment in the treatment of anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC). Often studies show only incremental improvements with a new treatment. This is different. Alectinib [Alecensa] shows a dramatic increase in efficacy that is also accompanied by better tolerability,” stated ASCO expert John Heymach, MD, Professor and Chairman of the Department of Thoracic/Head and Neck Medical Oncology at The University of Texas MD Anderson Cancer Center in Houston.

Here is an advance in efficacy and tolerability. Alectinib is a clear winner.
— John Heymach, MD

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“As Dr. Shaw pointed out, brain metastasis is the most common site of progression. Results of this trial showed an impressive, dramatic reduction in the likelihood of central nervous system progression. These are striking results,” Dr. Heymach continued. “Here is an advance in efficacy and tolerability. Alectinib is a clear winner,” he emphasized.

“Prior to this moment, the biggest advance in the field was a study comparing first-line crizotinib [Xalkori] vs chemotherapy for the treatment of ALK-positive NSCLC. That study found a progression-free survival of 7 months for chemotherapy vs 10.9 months for crizotinib. In the present study, you see more than doubling of progression-free survival beyond 15 months. I firmly agree with Dr. Shaw. This is a new standard of care for first-line ALK-positive lung cancer,” Dr. Heymach declared. ■

DISCLOSURE: Dr. Heymach reported no conflicts of interest.

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