Efficacy

Alecensa (Alectinib) Efficacy in Lung Cancer

Alecensa (alectinib) is a targeted therapy approved for the treatment of non-small cell lung cancer (NSCLC) with specific genetic alterations. It is particularly effective in NSCLC patients who have anaplastic lymphoma kinase (ALK) positive tumors, as determined by an FDA-approved test. Alectinib works by inhibiting the activity of the ALK protein, which can promote the growth of cancer cells in individuals with this mutation. Clinical trials have demonstrated that alectinib is effective in slowing the progression of ALK-positive NSCLC and can lead to higher response rates compared to chemotherapy and other ALK inhibitors.

In a pivotal phase III trial, the ALEX study, alectinib showed a significant improvement in progression-free survival (PFS) compared to crizotinib, another ALK inhibitor, in previously untreated ALK-positive NSCLC patients. The study also indicated that alectinib was more effective in controlling brain metastases, a common complication of lung cancer, suggesting a better central nervous system (CNS) penetration. The overall survival data also favored alectinib, although the results did not reach statistical significance at the time of interim analysis.

Cosela (Trilaciclib) Efficacy in Lung Cancer

Cosela (trilaciclib) is a different type of drug, known as a cyclin-dependent kinase (CDK) 4/6 inhibitor, which is used to help protect bone marrow function during chemotherapy for the treatment of extensive-stage small cell lung cancer (ES-SCLC). Trilaciclib is administered before chemotherapy to reduce the occurrence of chemotherapy-induced myelosuppression, which is the damage to bone marrow cells leading to reduced blood cell counts. By protecting bone marrow cells, trilaciclib aims to improve patient outcomes by allowing them to receive chemotherapy on schedule and potentially at higher doses.

The efficacy of trilaciclib in lung cancer was demonstrated in several clinical trials where it was shown to significantly reduce the incidence of severe neutropenia, a condition characterized by low levels of neutrophils, a type of white blood cell important for fighting infections. In these studies, patients with ES-SCLC who received trilaciclib before their chemotherapy regimen experienced fewer complications related to neutropenia, such as severe infections and hospitalizations, and were less likely to require interventions like granulocyte colony-stimulating factors (G-CSFs) to boost white blood cell counts. While trilaciclib is not a treatment for lung cancer itself, its role in supportive care is considered an important advancement in managing the side effects of chemotherapy.