Summary

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• Alunbrig (brigatinib) is 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.
• This summary is based on the review of 15 systematic review(s)/meta-analysis(es). ^[1-15]
• Brigatinib showed significant improvement in overall PFS compared to crizotinib (HR: 0.48, 95% CI: 0.35 to 0.66) and ceritinib (HR: 0.38, 95% CI: 0.23 to 0.60) in first-line treatment settings and was comparable to other second-generation ALK inhibitors.
• Brigatinib demonstrated robust intracranial PFS, with an iPFS of 19.26 months in patients with baseline brain metastases, indicating strong efficacy in treating brain metastases.
• The overall survival benefit of brigatinib was observed in comparison to crizotinib (HR: 0.50, 95% CI: 0.28 to 0.87), but it showed no significant difference in OS when compared to other next-generation ALK inhibitors.
• Brigatinib had a pooled ORR of 64% (95% CI 45%-83%) and a DCR of 88% (95% CI 80%-96%), demonstrating superior ORR to crizotinib and being comparable to other next-generation ALK inhibitors.
• Brigatinib had a higher rate of grade 3-4 adverse events (63.7%) compared to alectinib (16.2%) but lower than lorlatinib (91.6%) and similar to ensartinib and ceritinib.
• The most frequent adverse events associated with brigatinib included gastrointestinal reactions, hypertension, cough, headache, elevated ALT/AST levels, and increased creatine phosphokinase (CPK).
• Brigatinib's incidence of serious adverse events was comparable to other next-generation ALK inhibitors except for alectinib, which had a notably lower rate.
• Brigatinib was particularly effective in patients with baseline brain metastases, showing significant intracranial progression-free survival (iPFS), and demonstrated comparable efficacy in Asian populations, although ensartinib sometimes showed superior efficacy in this subgroup.