Medication Outperforms Chemo for Some Lung Cancers

Artist Portrait B&WLung cancer remains the top cancer killer in the United States for both men and women. There are different forms of lung cancer, but the most common form is non–small-cell lung cancer (NSCLC). NSCLC accounts for approximately 85 percent of lung cancer cases, according to the American Cancer Society.

For a long time, chemotherapy has been the first-line treatment for NSCLC. Yet, chemotherapy is often hard on patients due to severe side effects. Now there is another option for certain patients. Last year Xalkori® (crizotinib) was approved by the U.S. Food and Drug Administration (FDA) as an oral medication for the treatment of NSCLC which has spread to other locations in patients who test positive for the ALK fusion gene.

The ALK fusion gene occurs in about 5% of NSCLC cases. Xalkori, as a molecularly targeted oral therapy, inhibits this gene with a relatively mild side effect profile. Prior to Xalkori, patients were treated with chemotherapy, which offered only limited success despite the difficult side effects.

Research continues to confirm Xalkori’s superiority to standard chemotherapy as a first-line treatment. A study this month in the New England Journal of Medicine showed that, for advanced ALK-positive NSCLC, patients do survive longer with Xalkori than chemotherapy. This study involved 343 patients who were randomly assigned to either the Xalkori group or the intravenous chemotherapy group. For those in the chemotherapy group, they could choose to start Xalkori after their chemotherapy was complete.

Patients in the Xalkori group had longer times without their cancers progressing (10.9 months compared to 7.0 months). As the researchers explain: “As compared with chemotherapy, crizotinib was associated with greater reduction in lung cancer symptoms and greater improvement in quality of life.” It’s clear that this medication is the better choice compared to chemotherapy for previously untreated advanced ALK-positive NSCLC.

Stephen C. Vogt, Pharm.D.
President and CEO
BioPlus Specialty Pharmacy


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Solomon BJ, Mok T, Kim D, et al. First-line crizotinib versus chemotherapy in ALK-positive lung cancer. N Engl J Med 2014;371:2167-77.

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