There are many treatment options for lung cancer, but the right one for you will depend on many factors including the type of lung cancer you have. Non-small-cell lung cancer (NSCLC) is the most common type of lung cancer. Alunbrig is a treatment option for certain people with NSCLC.
Is Alunbrig Right for Me?
Your health care provider will consider what type of lung cancer you have and whether it has spread to help choose the right treatment for you. Alunbrig is used for NSCLC that has spread to another part of your body. It is used specifically for people with an anaplastic lymphoma kinase (ALK) mutation (also called ALK-positive). About 5% of people with NSCLC are ALK-positive.
How Does Alunbrig Work for NSCLC?
Alunbrig is a targeted therapy known as a kinase inhibitor. Alunbrig blocks a specific type of protein called ALK kinase. When this protein is blocked, it helps stop cancer cells from growing and multiplying.
How Do I Take Alunbrig?
Alunbrig is a tablet you take one time each day. You can take it with or without food. Do not crush or chew the tablet. You should swallow it whole. If you miss a dose or vomit after taking a dose, you do not need to take an extra dose. Take your next dose at the regular time.
How Was Alunbrig Studied for NSCLC?
Alunbrig was studied in two ways for people with ALK-positive NSCLC – in people who had not been treated with an ALK-targeted medicine and in people who tried another ALK-targeted medicine that stopped working.
No previous ALK-targeted medicine
The ALTA-1L study compared Alunbrig with crizotinib (Xalkori) in people with advanced NSCLC that had spread locally or spread to another part of the body. Crizotinib is another kinase inhibitor that also targets ALK. The trial included 275 people – 137 received Alunbrig and 138 received crizotinib – who had not been treated with an ALK-targeted medicine.
The initial dose of Alunbrig was 90 milligrams daily, but this was increased to 180 milligrams daily after seven days, and people continued taking either Alunbrig or crizotinib until they did not tolerate treatment or until their disease progressed. The people were followed to see how long it took for their lung cancer to progress, meaning that the cancer grew or spread. This measurement is called progression-free survival or PFS.
The median age of people in the study was 59, meaning that half were younger and half were older. Their ages ranged from 27 to 89. A total of 61% of people were non-Asian and 39% were Asian. About 42% of people in the study were current smokers or smoked in the past, while around 58% never smoked.
Previous ALK-targeted medicine
The ALTA study included people with advanced NSCLC that had spread locally or spread to another part of the body whose cancer had progressed while taking crizotinib. People were either treated with Alunbring 90 milligrams daily or 90 milligrams daily for the first seven days, then 180 milligrams daily. A total of 222 people were included.
The people were monitored to see if their tumor shrank or disappeared. This measurement is called the objective response rate. An objective response can either be a partial response when the tumor shrinks or a complete response where the tumor disappears.
The median age of people in the study was 54, and their ages ranged from 18 to 82. A total of 67% of people were White, 31% were Asian, and 2% were another race. About 39% of the people in the study were current smokers or smoked in the past, while around 60% never smoked.
What Are the Main Benefits of Alunbrig Based on Studies?
No previous ALK-targeted medicine
The estimated median progression-free survival was 24 months for people who took Alunbrig compared to 11.1 months for the people who took crizotinib. This means that half of the people who took Alunbrig were alive without cancer progression for at least 24 months compared to 11.1 months for people who took crizotinib. People treated with Alunbrig had a 52% reduction in the risk of progression or death as compared with crizotinib.
This study also looked at the duration of response in people who had a response. Duration of response is how long the response lasted before people got worse. The middle duration of response was 33.2 months (ranging from 22.1 months to not reached) with Alunbrig compared with 13.8 months (ranging from 10.4 to 22.1 months) with crizotinib.
Your results may be different from what was seen in the studies.
Previous ALK-targeted medicine
In the group of people who were treated with the recommended dose of Alunbring (90 milligrams first, then 180 milligrams):
- 54% of people had an objective response, with 50% of people having a partial response and 3.6% having a complete response
- 67% of people with cancer that had spread to the brain had an objective response, with all people having a partial response
In the people treated with 90 milligrams daily:
- 45% of people had an objective response, with 44% of people having a partial response and 0.9% having a complete response
- 42% of people with cancer that had spread to the brain had an objective response, with 35% of people having a partial response and 7.7% having a complete response
Your results may be different from what was seen in the studies.
What Can I Do to Prevent or Manage Side Effects of Alunbrig?
Side effects are common with cancer treatments, but your health care provider can help you prevent or manage side effects. You should talk to your health care provider if you think you have a side effect related to Alunbrig. Your health care provider may need to change the dose of your medicine, pause the medicine, or stop the medicine to help manage your side effects.
Nausea. Try to eat small meals or snacks to prevent or manage nausea. Small amounts of food that is plain and easy to eat may help. You may need liquid nutritional supplements.
Tiredness. Try to eat a healthy diet and exercise when you can. Short naps or resting for short periods of time may help with tiredness. Usually, rest breaks should be 30 minutes or less. Try not to take on too much, and ask friends or family for help when you are tired.
Shortness of breath. Call your health care provider or call 911 if you have sudden shortness of breath or shortness of breath that you are worried about or will not go away. For usual shortness of breath, consider practicing deep breathing by inhaling through your nose and exhaling through pursed lips. If you have mild shortness of breath, it may help to remove or loosen tight fitting clothing and cool yourself off, since heat can make it harder to breathe.
Pain. Alunbrig may cause muscle pain. Call your health care provider right away if you have muscle pain, tenderness, or weakness. Your health care provider may recommend medicines to help with your pain. Other options might include acupuncture, hypnosis, or massage. Distractions may also help keep your mind off the pain.
Is There Any Cost Assistance Available?
There may be cost assistance to help you afford Alunbrig. You may have options even if you do not have health insurance. With the Alunbrig copay assistance program, you may have a $0 copay. Your health care provider will help you get started. You can find more information here or call 844-817-6468.
