Single-center phase 2 trial of first-line alectinib plus bevacizumab for non-small cell lung cancer with ALK rearrangement

Up to 25% of patients with ALK-rearranged non-small cell lung cancer (NSCLC) experience disease progression within the first year of targeted therapy. The phase 2 ALEK-B trial, at the Instituto Nacional de Cancerologia (Mexico City), evaluated the combination of alectinib and bevacizumab as first-line treatment for ALK-rearranged NSCLC patients (17.1% with brain metastases). The 12-month progression-free survival (PFS) rate was 97.1% (95% CI 92.6-100), whereas the 36 months rates for PFS, intracranial PFS and overall survival were 64.2% (56.1-85.2), 87.8 (74.0-96.6), and 87.9% (74.0-96.6), respectively. Grade 3-4 adverse events occurred in 46.3%; there were no grade 5 AEs. The authors conclude that these findings support the efficacy and safety of alectinib plus bevacizumab as first-line treatment for ALK-rearranged NSCLC.