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llpete

ALK Positive

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I was diagnosed in 2012 and completed treatment in dec of 2012. Test have been clear until dec 2016. My Oncologist said that I can start taking Crizontinib but that I also qualify for a Clinical study. A phase 3 Multi-center Open label study of Brigatinib versus Crizotinib in Patients with ALK positive Advance Lung Cancer. Has anyone participating or had participated in this study ?

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Ilpete,

Welcome here!

I am not a Brigatinib vrs. Crizotinib participant.  In fact, my NSCLC Squamous cell type is not responsive to tumor marker-based targeted therapy.  But, let's cast a wide net and see if we can rustle up some experience.

All hands - anyone with experience in the phase 3 Open label study of Brigatinib versus Crizotinib?  Advice on targeted therapy treatment of ALK positive adenocarcinoma may also be helpful.  

Stay the course.

Tom

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Hi, Ilpete,

I will share your post in the LCSC Facebook group and LUNGevity ALK Facebook group to see if we can find any members who can answer your questions!

Lauren
--
Digital Community Manager
LUNGevity Foundation

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Hi!

I was diagnosed December 2015 with stage 4 with alk positive and was put on Crizontinib first and it stoped the growth of it it but that was it so my oncologist decided to put me on alencensa (alectinib) in April 2016 and it has shrunk all my lymph nodes back to normal tumor was in 90% of my lung but now it is just in the base and have had 7 months of normal blood work. I haven't heard of the study of the other drug but wanted to let you know of my results and I know results will be different between patients. Hope this all makes sense.

Jeffrey


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If I recall correctly, Alecensa (alectinib) was showing especially promising results as one's first ALK-targeted drug (odds of benefit & esp. longest duration), so good that it raised the question of whether it might actually be the best drug for that role although it would take a head-to-head phase 3 trial (two groups each randomly being assigned to or the other) to give a definitive answer.

brigatinib has been considered a good 2nd line choice after crizotinib although with a risk of pneumonitis reaction.  With their phase-in approach to dosing there isn't much concern over fatal pneumonitis reaction but if pneumonitis does occur (not usual but it does occur in some patients) you could find yourself (1) excluded from certain other clinical trials of new treatments because of having had that before or (2) excluded from some future trial if they have a restriction on the number of prior ALK inhibitors tried and you've run through a couple of others by then (such trials are becoming scarcer but they had existed before).  Most people wouldn't be too concerned with these when picking their 1st ALK drug, but there are anecdotes of individuals who turned out to be unlucky with one drug or another.  I am ignorant of any data on whether or not it might have any significant advantage over crizotinib as one's first ALK drug, and I thought that as a 2nd line (after crizotinib) it was performing well, so brigatinib is certainly a respectable drug.

Whenever the choice of treatment seems difficult, you (or your oncologist) should really consult with one of the top research oriented oncologists who have been involved with trials of these drugs from phase 1 on.  E.g., Ross Camidge at U. Colorado or Alice Shaw at MGH in Boston are tops in my book (and Camidge even offers phone consultations although insurance won't cover those).  Shaw is my oncologist (got 5 years out of crizotinib for ROS1+ due to meeting her when other docs only knew of chemo for ROS1), and I've met Camidge a few times at the big annual ASCO -- both are awesome.  Don't just assume a comment you hear on the internet reflects the latest thinking -- these doc know the latest because they are doing the work earlier and longer.

Best hopes,

Craig in PA

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Can't say that I have. I was started on Xalkori immediately following diagnosis of ALK positive adenocarcinoma. I got great results with few side effects for 29 months then scans showed some slight progression and my oncologist felt it was time to switch to Alecensa which penetrates the blood brain barrier. I have been on it close to 3 months now with few side effects and my blood work looks good. I will have my first scan after beginning the Alecensa in a week and will let you know how it is working.

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