Crizotinib

(Xalkori®)

Crizotinib

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Drug updated on 6/11/2024

Dosage FormCapsule (oral; 200 mg, 250 mg); pellet (oral; 20 mg, 50 mg, 150 mg)
Drug ClassKinase inhibitors
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • For the treatment of adult patients with metastatic non-small cell lung cancer (NSCLC) whose tumors are anaplastic lymphoma kinase (ALK) or ROS1-positive as detected by an FDA-approved test.
  • For the treatment of pediatric patients 1 year of age and older and young adults with relapsed or refractory, systemic anaplastic large cell lymphoma (ALCL) that is ALK-positive.
  • For the treatment of adult and pediatric patients 1 year of age and older with unresectable, recurrent, or refractory inflammatory myofibroblastic tumor (IMT) that is ALK-positive.

Summary
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  • Crizotinib (Xalkori) is indicated for the treatment of adult patients with metastatic non-small cell lung cancer (NSCLC) whose tumors are anaplastic lymphoma kinase (ALK) or ROS1-positive, pediatric and young adults with relapsed or refractory ALK-positive systemic anaplastic large cell lymphoma, and unresectable, recurrent, or refractory inflammatory myofibroblastic tumor that is ALK-positive.
  • The information was derived from 39 systematic reviews/meta-analyses focusing on Xalkori's comparison to other ALK-inhibitors in treating various types of ALK-positive conditions.
  • Alectinib has significant advantages over Xalkori in both first and second-line settings for advanced ALK-positive NSCLC. It showed the longest overall survival among all inhibitors and had high progression-free survival rates for patients pre-treated with Xalkori.
  • Lorlatinib surpasses Xalkori in terms of progression-free survival globally but shows a poorer safety profile compared to Alectinib. However, it effectively reduces the risk of central nervous system progression which is crucial when treating NSCLC.
  • Brigatinib and Ceritinib show improvements in progression-free survival (PFS) when compared to Xalkori but have higher incidences of adverse events, reducing their safety profiles. Despite this, Brigatinib performs well regarding patient-reported outcomes suggesting potential quality-of-life benefits despite its safety profile.
  • Ensartinib was more effective than a second-generation inhibitor especially within subgroups having central nervous system (CNS) metastases, while low-dose Alectinib's efficacy wasn't as highlighted as others'.
  • Xalkori continues playing a role due to comparative benefits concerning side effects and risks associated with discontinuation even though several second and third-generation inhibitors surpassed it regarding efficacy and safety.
  • The effectiveness varies significantly based on patient subgroups particularly between global and Asian populations. Patients with CNS metastases at baseline showed better outcomes with Lorlatinib and Alectinib, emphasizing these drugs' ability to manage this challenging condition associated with ALK-positive NSCLC.

Product Monograph / Prescribing Information

Document TitleYearSource
Xalkori (crizotinib) Prescribing Information.2023Pfizer Inc., New York, NY

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
Comparing efficacy and safety of upfront treatment strategies for anaplastic lymphoma kinase-positive non-small cell lung cancer: A network meta-analysis.2023Exploration of anti-tumour targeted therapy
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
Alectinib for treating patients with metastatic ALK-positive NSCLC: Systematic review and network metanalysis.2023Lung Cancer Management
Adverse Side Effects of Crizotinib in the Treatment of Anaplastic Lymphoma Kinase-Mutated Non-small Cell Lung Cancer: A Systematic Review.2023Cureus
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
Safety and efficacy of alectinib versus crizotinib in alk-positive non-small cell lung cancer: An update meta-analysis.2023Pakistan Journal of Pharmaceutical Sciences
Identification of cardiotoxicity related to non-small cell lung cancer (NSCLC) treatments: A systematic review.2023Frontiers in Pharmacology
A Bayesian network meta-analysis of ALK inhibitor treatments in patients with ALK-positive non-small cell lung cancer.2023Cancer Medicine
Efficacy and safety of anaplastic lymphoma kinase inhibitors for non-small cell lung cancer: A systematic review and network meta-analysis.2023Thoracic Cancer
Risks of cardiovascular toxicities associated with ALK tyrosine kinase inhibitors in patients with non-small-cell lung cancer: A meta-analysis of randomized control trials.2023Expert Opinion on Drug Safety
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
Non-small cell lung cancer with MET amplification: review of epidemiology, associated disease characteristics, testing procedures, burden, and treatments2023Frontiers in Oncology
Targeted therapy for advanced anaplastic lymphoma kinase (ALK)-rearranged non‐small cell lung cancer.2022The Cochrane Database of Systematic Reviews
Toxicity profile of anaplastic lymphoma kinase tyrosine kinase inhibitors for patients with non-small cell lung cancer: A systematic review and meta-analysis.2022Investigational New Drugs
A systematic review of companion diagnostic tests by immunohistochemistry for the screening of alectinib-treated patients in ALK-positive non-small cell lung cancer.2022Diagnostics
Beyond Crizotinib: A systematic review and meta-analysis of the next-generation ALK inhibitors as first-line treatment for ALK-translocated lung cancer.2022Frontiers in Oncology
ALK inhibitors in ALK-rearranged non-small cell lung cancer with and without brain metastases: Systematic review and network meta-analysis.2022BMJ Open
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
Crizotinib versus Alectinib for the Treatment of ALK-Positive Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis.2022Chemotherapy
Comparison of lorlatinib, alectinib and brigatinib in ALK inhibitor-naive/untreated ALK-positive advanced non-small-cell lung cancer: A systematic review and network meta-analysis.2022Journal of Chemotherapy
Comparison of clinical efficacy of alectinib versus crizotinib in ALK-positive non-small cell lung cancer: A meta-analysis.2021Frontiers 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
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
Systematic review and network meta-analysis of anaplastic lymphoma kinase (ALK) inhibitors for treatment-naïve ALK-positive lung cancer.2021Cancers
Efficacy and Safety of First-Line Treatment Strategies for Anaplastic Lymphoma Kinase-Positive Non-Small Cell Lung Cancer: A Bayesian Network Meta-Analysis.2021Frontiers in Oncology
ALK inhibitor-induced bradycardia: A systematic-review and meta-analysis.2021Lung Cancer
Crizotinib Versus Conventional Chemotherapy in First-Line Treatment for ALK-Positive Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis.2021Oncology and Therapy
Efficacy and safety of crizotinib in the treatment of advanced non-small-cell lung cancer with ROS1 rearrangement or MET alteration: A systematic review and meta-analysis.2020Targeted Oncology
Effect of alectinib versus crizotinib on progression-free survival, central nervous system efficacy and adverse events in ALK-positive non-small cell lung cancer: A systematic review and meta-analysis.2020Annals of Palliative Medicine
ALK inhibitors for non-small cell lung cancer: A systematic review and network meta-analysis.2020PLoS One
Matching-adjusted indirect comparison: entrectinib versus crizotinib in ROS1 fusion-positive non-small cell lung cancer.2020Journal of Comparative Effectiveness Research
Efficacy and safety of ceritinib in anaplastic lymphoma kinase-rearranged non-small cell lung cancer: A systematic review and meta-analysis.2020Journal of Clinical Pharmacy and Therapeutics
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-Analysis2020Cancers
Crizotinib versus chemotherapy on ALK-positive NSCLC: a systematic review of efficacy and safety.2019Current Cancer Drug Targets
Meta-analysis comparing incidence of grade 3–4 neutropenia with ALK inhibitors and chemotherapy in patients with non-small-cell lung cancer.2019Future Medicine
Safety issues with the ALK inhibitors in the treatment of NSCLC: A systematic review.2019Critical Reviews in Oncology/Hematology
The incidence of ALK inhibitor-related pneumonitis in advanced non-small-cell lung cancer patients: A systematic review and meta-analysis.2019Lung Cancer
Meta-analysis of overall incidence and risk of ALK inhibitors-induced liver toxicities in advanced non-small-cell lung cancer.2019Medicine
Crizotinib Versus Chemotherapy on ALK-positive NSCLC: A Systematic Review of Efficacy and Safety.2019Current Cancer Drug Targets

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