Alectinib in Resected ALK-Positive Non–Small-Cell Lung Cancer
RCT (n=257, stage IB, II, or IIIA) found adjuvant alectinib significantly improved disease-free survival vs platinum-based chemotherapy, with 93.8% vs 63.0%, respectively alive and disease-free at 2 years (HR 0.24; 95% CI, 0.13 to 0.45; p<0.001).
Source:
New England Journal of Medicine
SPS commentary:
An editorial notes that crucial questions arise when this trial is meticulously evaluated and its design and results are compared and integrated with those from the proof-of-concept ADAURA trial, primarily concerns over the feasibility of incorporating additional biologic therapies in the adjuvant context. It adds that this brings forth the need for a cautious examination of the long-term safety profiles of these therapies, especially given their application in the adjuvant context in which treatment is given to patients with no evidence of active disease. It thus highlights that the transition from treating metastatic disease with curative intent in early-stage cancers introduces new dynamics in the risk–benefit analysis.