Health In Focus
  • The results of ALEX trial were presented at the European Lung Cancer Congress (ELCC ) 2018 by Dr. Pérol supporting the use of alectinib in lung cancer.
  • Alectinib, a next generation tyrosine kinase inhibitor found to be the frontline treatment in patients with ALK-positive non-small-cell lung cancer.
  • When compared with the standard crizotinib therapy, alectinib improves the symptoms of lung cancer with a better toxicity profile.

Lung cancer or lung carcinoma is one of the most common and serious cancers worldwide. Lung cancer occurs due to an uncontrolled growth of abnormal cells either in single or both lungs, which usually affects older people. Smoking is found to be the major cause of lung cancer, due to the continuous inhalation of toxic substances like nicotine. Exposure to asbestos, radiation and high levels of air pollution are other risks that leads to lung cancer.

Findings of ALEX trial

The burden of symptoms in lung cancer is usually high, with episodes of chest pain, cough and difficulty in breathing. It is necessary to provide palliation in such terminal illness, with the main focus to improve the symptoms associated with lung cancer. Crizotinib, a standard medication in treating the ALK-positive non-small-cell lung cancer does not improve long-term symptoms of lung cancer.
Alectinib May Be Drug Of Choice to Treat Non-Small-Cell Lung Cancer

The phase 3 Alex trial was conducted to compare the effects of alectinib and crizotinib and the results were presented at the European Lung Cancer Congress (ELCC) 2018 by Dr. Pérol. The results of ALEX trial showed that alectinib can be a drug of choice in treating ALK-positive non-small-cell lung cancer. Patients were grouped into two, receiving alectinib and crizotinib respectively, and were evaluated based on the health-related quality of life and symptoms. During the study, patients were asked to complete two questionnaires - EORTC QLQ-C30 and EORTC QLQ-LC13.

Patient groups treated with alectinib and crizotinib showed an improvement in health-related quality of life. However, patients treated with alectinib showed a longer improvement of symptoms when compared with crizotinib. Alectinib was also found to increase the progression free survival rate (PFS) and delay the disease progression into the central nervous system (CNS) than the standard crizotinib therapy.

Alectinib worsens the cognitive function in few patients with CNS metastases. However, the tolerability profile and the health-related quality of life along with improvement in symptoms was found to be superior with alectinib when compared with crizotinib. The research team suggested that alectinib can be considered as a first-line palliative treatment for ALK-positive non-small-cell lung cancer.

What are the causes of non-small-cell lung cancer?

  • Tobacco smoking
  • Gene changes or mutation
  • Severe air pollution
  • Exposure to the following
    • Asbestos Smoke
    • Radon
    • Diesel exhaust
    • Other chemicals

How can you diagnose non-small-cell lung cancer?

  • Chest X-ray
  • Pulmonary function tests
  • Complete blood tests
  • Immunohistochemical test
  • Endobronchial ultrasound
  • Computed tomography (CT) scan
  • Magnetic resonance imaging
  • Positron emission tomography (PET) scan
  • Sputum test
  • Thoracentesis
  • Biopsy
  • Bronchscopy
  • Mediastinoscopy
  • Mediastinotomy
  • Thoracoscopy
References :
  1. About Non-Small Cell Lung Cancer - (
  2. What Is Lung Cancer? - (

Source: Medindia

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