FDA Approves Genentech's Alecensa as First Adjuvant Treatment for People With ALK-Positive Early-Stage Lung Cancer
– Approval based on Phase III ALINA study showing Alecensa reduced the risk of disease recurrence or death by an unprecedented 76% in people with ALK-positive early-stage resected non-small cell lung cancer (NSCLC) –
– This approval helps address an urgent unmet need, with about half of people living with early-stage NSCLC experiencing disease recurrence following surgery, despite adjuvant chemotherapy –
– The National Comprehensive Cancer Network® (NCCN®) Guidelines recommend routine testing for ALK, EGFR and PD-L1 biomarkers in people with early-stage NSCLC to inform adjuvant therapy selection –
“With an unprecedented 76% reduction in the risk of disease recurrence or death versus chemotherapy, Alecensa significantly improves upon the standard of care for people with early-stage ALK-positive lung cancer,” said
“The approval of Alecensa marks a pivotal moment for people newly diagnosed with early-stage ALK-positive lung cancer, who until now, were not able to receive ALK-specific therapy,” said
The approval is based on positive results from the Phase III ALINA study that demonstrated Alecensa reduced the risk of disease recurrence or death by 76% (hazard ratio [HR]=0.24, 95% CI: 0.13-0.43, p<0.0001) compared with platinum-based chemotherapy in people with completely resected IB (tumor ≥ 4 cm) to
Alecensa is a kinase inhibitor currently approved as first- and second-line treatment for ALK-positive metastatic NSCLC. It has demonstrated significant efficacy in patients, including those with CNS metastases, and now with this approval, these benefits could extend to people with early-stage disease. Routine testing of resected surgical tissue or biopsy for ALK, EGFR and PD-L1 biomarkers in patients with stage IB to
The review of this application was conducted under the FDA’s
About the ALINA study
The ALINA study [NCT03456076] is a Phase III, randomized, active-controlled, multicenter, open-label study evaluating the efficacy and safety of adjuvant Alecensa® (alectinib) compared with platinum-based chemotherapy in people with resected Stage IB (tumor ≥ 4 cm) to
About lung cancer
According to the
About Alecensa® (alectinib)
Alecensa is a prescription medicine used to treat people with non-small cell lung cancer (NSCLC) that is caused by an abnormal anaplastic lymphoma kinase (ALK) gene. It can be used to help prevent lung cancer from coming back in patients after their tumor has been removed by surgery (adjuvant), or to treat patients when their lung cancer has spread to other parts of the body (metastatic).
A doctor will perform a test to make sure that Alecensa is right for their patient. It is not known if Alecensa is safe and effective in children.
Important Safety Information
Everyone reacts differently to treatment with Alecensa. It’s important to know the most serious and most common side effects with Alecensa.
A doctor may lower the dose or stop treatment with Alecensa if any side effects occur. Patients taking Alecensa should contact their doctor right away if they have any of the following side effects.
Alecensa may cause serious side effects, including:
Liver problems (hepatotoxicity). Liver problems are common with Alecensa and can be severe. A doctor will do blood tests at least every 2 weeks for the first 3 months, and then 1 time each month and as needed during treatment with Alecensa. Patients taking Alecensa should tell their doctor right away if they experience any of the following signs and symptoms:
- Feeling tired
- Feeling less hungry than usual
- Yellowing of the skin or whites of the eyes
- Dark urine
- Itchy skin
- Nausea or vomiting
- Pain on the right side of stomach area
- Bleeding or bruising more easily than normal
Lung problems. Alecensa may cause severe or life-threatening swelling (inflammation) of the lungs during treatment. Symptoms may be similar to those symptoms from lung cancer. Patients taking Alecensa should tell their doctor right away if they have any new or worsening symptoms, including trouble breathing, shortness of breath, cough, or fever.
Kidney problems. Alecensa may cause severe kidney problems that can lead to death. Patients should tell their doctor right away if they have a change in the amount or color of their urine, or if they get new or worsening swelling in their legs or feet.
Slow heartbeat (bradycardia). Alecensa may cause very slow heartbeats that can be severe. A doctor will check a patient’s heart rate and blood pressure during treatment with Alecensa. Patients taking Alecensa should tell their doctor right away if they feel dizzy, lightheaded, or if they faint during treatment with Alecensa. Patients taking Alecensa should tell their doctor if they take any heart or blood pressure medicines.
Severe muscle pain, tenderness, and weakness (myalgia). Muscle problems are common with Alecensa and can be severe. A doctor will do blood tests at least every 2 weeks for the first month and as needed during treatment with Alecensa. Patients taking Alecensa should tell their doctor right away if they have any new or worsening signs and symptoms of muscle problems, including unexplained muscle pain or muscle pain that does not go away, tenderness, or weakness.
Breakdown of healthy red blood cells earlier than normal (hemolytic anemia). Hemolytic anemia can happen in some people who take Alecensa. If this happens, patients may not have enough healthy red blood cells. A doctor may temporarily stop Alecensa and do blood tests, if needed, to check for this problem. If patients develop hemolytic anemia, their doctor may either restart them on Alecensa at a lower dose when the hemolytic anemia goes away, or may stop treatment with Alecensa. Patients should tell their doctor right away if they experience yellow skin (jaundice), weakness or dizziness, or shortness of breath.
Before taking Alecensa, patients should tell their doctor about all medical conditions, including if they:
- have liver problems
- have lung or breathing problems
- have a slow heartbeat
-
are pregnant or plan to become pregnant. Alecensa can harm an unborn baby.
- Females who are able to become pregnant will be tested by their doctor to see if they are pregnant before starting treatment with Alecensa. They should use effective birth control (contraception) during treatment with Alecensa and for 5 weeks after the last dose of Alecensa. Patients taking Alecensa should tell their doctor right away if they become pregnant during treatment with Alecensa or think they may be pregnant
- Males who have female partners that are able to become pregnant should use effective birth control (contraception) during treatment with Alecensa and for 3 months after the last dose of Alecensa
- are breastfeeding or plan to breastfeed. It is not known if Alecensa passes into breast milk. A patient should not breastfeed during treatment with Alecensa and for 1 week after the last dose of Alecensa. Patients should talk with their doctor about the best way to feed their baby during this time.
Patients taking Alecensa should tell their doctor about all the medicines they take, includingprescription medicines, over-the-counter medicines, vitamins, and herbal supplements.
Patients taking Alecensa should avoid spending time in the sunlight during treatment with Alecensa and for 7 days after the last dose of Alecensa. Patients taking Alecensa may be sensitive to the sun (photosensitivity), burn more easily and get severe sunburns. Patients taking Alecensa should use sunscreen and lip balm with an SPF 50 or greater to help protect against sunburn.
The most common side effects of Alecensa include:
- constipation
- tiredness
- swelling in hands, feet, ankles, face, and eyelids
- rash
- cough
These are not all of the possible side effects of Alecensa. For more information, patients should ask their doctor or pharmacist. Patients should call their doctor for medical advice about side effects.
Report side effects to the FDA at (800) FDA-1088 or http://www.fda.gov/medwatch. Patients and caregivers may also report side effects to
Please see additional Important Safety Information in full Prescribing Information , including Patient Information .
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