Summary

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• This summary is based on the review of 33 systematic review(s)/meta-analysis(es). ^[1-33]
• Lorlatinib: Demonstrates superior progression-free survival (PFS) over crizotinib with hazard ratios (HRs) of 0.61 (95% CrI: 0.39, 0.97) versus alectinib and 0.57 (95% CrI: 0.35, 0.93) versus brigatinib; ranks highest for objective response rate (ORR) among ALK (anaplastic lymphoma kinase) inhibitors.
• Alectinib: Significantly prolongs PFS in both first-line and second-line settings compared to crizotinib and shows a lower grade 3-4 adverse event rate (16.2%) compared to other ALK inhibitors, making it the safest option in terms of adverse effects.
• Crizotinib: Shows a median PFS of 14.5 months and a median overall survival (OS) of 40.2 months in ROS1-positive NSCLC real-world settings; notable for a pooled ORR of 70.6% but associated with higher risks of thromboembolism and venous thromboembolism compared to brigatinib and ceritinib.
• Iruplinalkib: Ranked highest for cumulative PFS benefit (SUCRA (surface under the cumulative ranking curve)) among ALK inhibitors, especially effective in Asian patient populations, with subsequent rankings favoring brigatinib and ensartinib for this subgroup.
• Lorlatinib: Has a high incidence of grade 3-4 adverse events, occurring in 91.6% of cases, with specific events including cognitive and mood effects, as well as lipid level alterations.
• Crizotinib: Demonstrates elevated risks for thromboembolism and venous thromboembolism relative to brigatinib and ceritinib, along with gastrointestinal reactions, visual disorders, and elevated liver enzymes.
• There is no population types or subgroups information available in the reviewed studies.