The activity, safety, and evolving role of brigatinib in patients with ALK-rearranged non-small cell lung cancers Journal Article


Authors: Sabari, J. K.; Santini, F. C.; Schram, A. M.; Bergagnini, I.; Chen, R.; Mrad, C.; Lai, W. V.; Arbour, K. C.; Drilon, A.
Article Title: The activity, safety, and evolving role of brigatinib in patients with ALK-rearranged non-small cell lung cancers
Abstract: Brigatinib (AP26113) is a dimethylphosphine oxide group-containing tyrosine kinase inhibitor (TKI) constructed around a bisanilinopyrimidine scaffold with potent activity against the anaplastic lymphoma kinase (ALK) and several other targets. Despite the activity of first- and second-generation ALK inhibitors in advanced ALK-rearranged lung cancers, the development of acquired resistance represents an ongoing challenge. Later generation ALK inhibitors such as brigatinib are important potential tools in the management of patients with acquired resistance characterized by continued dependency on ALK. Brigatinib is active in vitro against many ALK kinase domain mutations that may mediate acquired resistance to other ALK TKIs, with reported activity (IC50 <50 nM) against ALK C1156Y, I1171S/T, V1180L, L1196M, L1152R/P, E1210K, and G1269A. In patients with ALK-rearranged lung cancers who receive brigatinib after crizotinib, substantial and durable responses and intracranial disease control can be achieved based on early-phase clinical trial data. The drug is also being explored in TKI-naïve patients. From a safety perspective, early pulmonary toxicity has been observed, prompting the decision to pursue lead-in dosing for the drug. Early data point to ALK G1202R and ALK E1210K as potential mechanisms of clinical resistance to brigatinib. © 2017 Sabari et al.
Keywords: tyrosine kinase inhibitor; alk; nsclc; acquired resistance; crizotinib; ceritinib; alectinib; brigatinib; lorlatinib
Journal Title: OncoTargets and Therapy
Volume: 10
ISSN: 1178-6930
Publisher: Dove Medical Press Ltd  
Date Published: 2017-04-06
Start Page: 1983
End Page: 1992
Language: English
DOI: 10.2147/ott.s109295
PROVIDER: scopus
PMCID: PMC5388194
PUBMED: 28435288
DOI/URL:
Notes: Review -- Export Date: 2 May 2017 -- Source: Scopus
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MSK Authors
  1. Alexander Edward Drilon
    632 Drilon
  2. Alison Michele Schram
    122 Schram
  3. Joshua K Sabari
    36 Sabari
  4. Kathryn Cecilia Arbour
    88 Arbour
  5. Wei-Chu Victoria Lai
    59 Lai
  6. Fernando Costa Santini
    22 Santini
  7. Ruqin Chen
    2 Chen
  8. Chebli Mrad
    2 Mrad