Key Considerations for First-Line ALK Inhibitor Treatment Selection
Panelists discuss how they guide first-line ALK inhibitor selection based on efficacy, tolerability, clinical data, and patient-specific considerations.
This segment dives into the decision-making process behind selecting a first-line ALK inhibitor. Panelists discuss how efficacy, tolerability, CNS penetration, and patient lifestyle influence drug choice. Trials such as CROWN, ALEX, and ALTA-1L offer critical data comparing options like alectinib, brigatinib, and lorlatinib.
The discussion emphasizes shared decision-making, with clinicians guiding patients through risks and benefits based on their individual needs. For example, alectinib may be preferred for its tolerability, while lorlatinib may be more effective for patients with brain metastases but requires more monitoring for neurocognitive adverse effects.
Biomarker-driven therapy is strongly preferred over chemotherapy due to better survival outcomes and fewer systemic adverse effects. The segment explains how ALK-positive tumors often develop resistance to platinum-based chemotherapy, reinforcing the need for targeted treatments as first-line options in this molecular subgroup.
