Evidence map›Paper›PMID 41074399›Full record

Observational studyThoracic cancer2025

Real-World Outcomes of Brigatinib Compared to Alectinib as a Second-Line Therapy After Crizotinib in Advanced Anaplastic Lymphoma Kinase Positive Non-Small Cell Lung Cancer Patients.

Min Jee Kim, Hyun Seok Kwak, Eun Nim Koh, Cheol-Kyu Park, Young-Chul Kim, In-Jae Oh, Seung Joon Kim, Jun Hyeok Lim, Jeong-Seon Ryu, Chang Min Choi

Abstract readComparative StudyMulticenter StudyObservational Study
In one paragraph

Observational study in Thoracic cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Min Jee KimDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.ORCID https://orcid.org/0000-0003-0073-2079
Hyun Seok KwakDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Eun Nim KohDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Cheol-Kyu ParkDepartment of Internal Medicine, Chonnam National University Medical School, Hwasun, Republic of Korea.
Young-Chul KimDepartment of Internal Medicine, Chonnam National University Medical School, Hwasun, Republic of Korea.
In-Jae OhDepartment of Internal Medicine, Chonnam National University Medical School, Hwasun, Republic of Korea.
Seung Joon KimDivision of Pulmonology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Jun Hyeok LimDivision of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea.ORCID https://orcid.org/0000-0001-5515-737X
Jeong-Seon RyuDivision of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea.
Chang Min ChoiDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Funding

Takeda Pharmaceuticals Korea Co., Ltd.
6 · The paper itself

Abstract

backgroundSecond-generation anaplastic lymphoma kinase (ALK) inhibitors, including alectinib and brigatinib, are widely used in patients with ALK-positive non-small cell lung cancer (NSCLC) who develop resistance or progress on crizotinib. However, real-world data comparing their efficacy and safety remain limited. This multicenter, prospective cohort study compared the clinical outcomes of alectinib and brigatinib in this setting.

methodsPatients with stage IV ALK-positive NSCLC who progressed on crizotinib were enrolled and treated with either brigatinib or alectinib. The primary endpoint was the progression-free survival (PFS) rate.

resultsSixty patients were included (brigatinib, n = 34; alectinib, n = 26). Median follow-up durations were 26.5 and 30.0 months. Disease progression or death occurred in 50.0% (brigatinib) and 46.2% (alectinib), respectively. The 3-year PFS was 51.5% (brigatinib) vs. 62.1% (alectinib), with no significant difference at 5 years (40.0% vs. 42.5%; p = 0.260). Overall response rates were similar (58.8% vs. 46.2%; p = 0.475). However, intracranial outcomes appeared more favorable with alectinib: the 3-year intracranial PFS was 70.5% vs. 31.7% (p = 0.023), and intracranial ORR was 94.4% vs. 64.3% (p = 0.028). More patients in the brigatinib group had prior whole-brain radiotherapy (21.4% vs. 5.6%), while radiosurgery was more frequent in the alectinib group (55.6% vs. 35.7%). Treatment discontinuation rates due to adverse events were comparable between the two groups.

conclusionsIn crizotinib-refractory ALK-positive NSCLC, systemic efficacy was not significantly different between brigatinib and alectinib; however, alectinib was associated with more favorable intracranial PFS and ORR, which may be partly explained by differences in prior brain-directed local treatments.

Indexed as

Anaplastic Lymphoma KinaseCarbazolesCarcinoma, Non-Small-Cell LungCrizotinibLung NeoplasmsOrganophosphorus CompoundsPiperidinesProtein Kinase InhibitorsPyrimidinesAdultAgedFemaleHumansMaleMiddle AgedProspective StudiesalectinibALK protein, humanAnaplastic Lymphoma KinasebrigatinibCarbazolesCrizotinibOrganophosphorus CompoundsPiperidinesProtein Kinase InhibitorsPyrimidinesAlectinibALK‐positive non‐small cell lung cacnerBrigatinibsecond‐line treatment

Identifiers

PMID41074399
PMCPMC12514014

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.