Brigatinib

(Alunbrig®)

Brigatinib

Drug updated on 5/17/2024

Dosage FormTablet (oral; 30 mg, 90 mg, 180 mg)
Drug ClassKinase inhibitors
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the treatment of adult patients with anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC) as detected by an FDA-approved test.

Latest News

loading GIF

Summary
This AI-generated content is provided without warranty and may be inaccurate or outdated, with no liability accepted for reliance on it. Learn more.

  • Brigatinib (Alunbrig) is recommended for adult patients with anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC) due to its significant advantages in progression-free survival, particularly when compared with other ALK inhibitors such as crizotinib and ceritinib.
  • A total of 15 studies provided a comprehensive comparison regarding brigatinib's efficacy and safety among adult patients with ALK-positive NSCLC.
  • Brigatinib demonstrates comparable progression-free survival to second-generation ALK inhibitors such as lorlatinib and alectinib. Its effectiveness is especially pronounced in patients with central nervous system metastases due to its high intracranial response rates.
  • Safety profiles indicate that brigatinib has a similar incidence rate of grade 3 adverse events compared to other second-generation ALK inhibitors, except for alectinib, which exhibits a better safety profile across most studies. Common side effects associated with brigatinib include increased creatine phosphokinase levels, diarrhea, and nausea.
  • The tolerance profile for brigatinib was manageable relative to higher toxicities associated with lorlatinib, including hyperlipidemia, weight gain, mood effects, and cognitive impacts.
  • Brigatinib shows substantial efficacy across global populations, including Asian patient groups previously treated by crizotinib, although it was outperformed by alectinib and ensartinib in terms of progression-free survival within this subgroup.
  • Brigatinib also demonstrated strong intracranial responses, making it a useful option for those harboring CNS metastases at baseline, positioning it close behind lorlatinib in efficacy within this challenging clinical scenario.
  • Alectinib often emerges as the preferable choice, balancing both efficacy and safety, particularly for Asian patients and those with CNS metastases. However, brigatinib stands out in terms of patient-reported outcomes, making it a valuable contender, especially for patients who prioritize quality of life alongside treatment efficacy.

Product Monograph / Prescribing Information

Document TitleYearSource
Alunbrig (Brigatinib) Prescribing Information.2022Takeda Pharmaceutical Company Limited, Cambridge, MA

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Identifying optimal ALK inhibitors in first- and second-line treatment of patients with advanced ALK-positive non-small-cell lung cancer: a systematic review and network meta-analysis.2024BMC Cancer
Comparative efficacy of ALK inhibitors for treatment-naïve ALK-positive advanced non-small cell lung cancer with central nervous system metastasis: a network meta-analysis.2023International Journal of Molecular Sciences
Efficacy and safety of first-line treatments for patients with advanced anaplastic lymphoma kinase mutated, non-small cell cancer: a systematic review and network meta-analysis.2023Cancer
Comparative safety of anaplastic lymphoma kinase tyrosine kinase inhibitors in advanced anaplastic lymphoma kinase-mutated non-small cell lung cancer: systematic review and network meta-analysis.2023Lung Cancer
A Bayesian network meta-analysis of ALK inhibitor treatments in patients with ALK-positive non-small cell lung cancer.2023Cancer Medicine
Alectinib for treating patients with metastatic ALK-positive NSCLC: systematic review and network metanalysis.2023Lung Cancer Management
Comparison of efficacy and safety of brigatinib in first-line treatments for patients with anaplastic lymphoma kinase-positive non-small-cell lung cancer: a systematic review and indirect treatment comparison.2022Journal of Clinical Medicine
Targeted therapy for advanced anaplastic lymphoma kinase (ALK)‐rearranged non‐small cell lung cancer.2022The Cochrane Database of Systematic Reviews
Efficacy and safety of brigatinib in ALK-positive non-small cell lung cancer treatment: a systematic review and meta-analysis.2022Frontiers in Oncology
Comparative efficacy and safety of lorlatinib and alectinib for alk-rearrangement positive advanced non-small cell lung cancer in Asian and non-Asian patients: a systematic review and network meta-analysis.2021Cancers
Systematic review and network meta-analysis of anaplastic lymphoma kinase (ALK) inhibitors for treatment-naïve ALK-positive lung cancer.2021Cancers
First-line anaplastic lymphoma kinase (ALK) inhibitors for ALK-positive lung cancer in Asian populations: systematic review and network meta-analysis.2021Journal of Clinical Medicine
Comparative efficacy and safety of first-line treatments for advanced non-small cell lung cancer with ALK-rearranged: a meta-analysis of clinical trials.2021BMC Cancer
Brigatinib and alectinib for ALK rearrangement-positive advanced non-small cell lung cancer with or without central nervous system metastasis: a systematic review and network meta-analysis.2020Cancers
ALK inhibitors for non-small cell lung cancer: a systematic review and network meta-analysis.2020PLoS One

Clinical Practice Guidelines