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. Zykadia (ceritinib) is a treatment option for certain people with NSCLC.
Is Zykadia 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. Zykadia 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 Zykadia Work for NSCLC?
Zykadia is a targeted therapy known as a kinase inhibitor. Zykadia blocks a specific type of kinase called ALK. When this kinase is blocked, it may help stop cancer cells from growing and multiplying.
How Do I Take Zykadia?
Zykadia is a tablet you take one time each day. You should take Zykadia with food. If you miss a dose, you can make up the dose as soon as possible unless the next dose is due within 12 hours. If you vomit after taking Zykadia, do not take another dose and continue with the next scheduled dose.
How Was Zykadia Studied for NSCLC?
Zykadia was studied in two ways for people with ALK-positive NSCLC:
- People who had not been treated with any cancer medicine
- People who tried another cancer medicine that was no longer working or was not tolerated
The primary study for people who had not been treated with another ALK-targeted medicine is known as the ASCEND-4 study. Two studies that included people who had already been treated with another ALK-targeted medicine are known as the ASCEND-1 study and the more recent ASCEND-5 study.
ASCEND-4 Study
The ASCEND-4 study compared Zykadia to chemotherapy in people with advanced NSCLC that had spread to nearby areas or to another part of the body. The trial included 376 people – 189 received Zykadia and 187 received chemotherapy – who had not been treated with cancer therapy after their disease had spread.
People continued treatment until they did not tolerate treatment or until their disease progressed. The participants 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 54, meaning that half were younger and half were older. A total of 54% of people were White, 42% were Asian, 2% were Black, and 2% were other races. About 39% of people in the study were current smokers or smoked in the past, while around 61% never smoked.
ASCEND-1 Study
In the ASCEND-1 study, 163 people with advanced NSCLC that had spread to nearby areas or to another part of the body who had progressed on or did not tolerate another ALK-targeted medicine, called crizotinib (Xalkori), were treated with Zykadia.
The people were followed 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 52. A total of 66% of people were White, 29% were Asian, about 2% were Black, and about 2% were another race. A total of 3% of people were current smokers and the remainder were never or former smokers.
ASCEND-5 Study
The ASCEND-5 study compared Zykadia to chemotherapy in people with advanced ALK-positive NSCLC that had spread to nearby areas or to another part of the body. The trial included 231 people — 115 received Zykadia and 116 received chemotherapy — who had received previous treatment with crizotinib and chemotherapy and got worse.
People continued treatment until they did not tolerate treatment or until their disease progressed. The participants were followed to measure progression-free survival.
The median age of people in the study was 54, meaning that half were younger and half were older. About 65% of people were White, about 29% were Asian, and about 6% of people were of other or unknown race. About 41% of the people in the study were current smokers or smoked in the past, while around 57% never smoked.
What Are the Main Benefits of Zykadia Based on Studies?
ASCEND-4 Study
After about 20 months of treatment, the median progression-free survival was 16.6 months for people who took Zykadia compared to 8.1 months for the people who received chemotherapy. This means that half of the people who took Zykadia did not have their cancer progress for at least 16.6 months compared to 8.1 months for people who received chemotherapy. People treated with chemotherapy were more likely to have their cancer worsen than those who were treated with Zykadia.
Your results may be different from what was seen in the studies.
ASCEND-1 Study
Overall, 55% of people had a response, with about 53% of people having a partial response and 1.2% having a complete response.
Your results may be different from what was seen in the studies.
ASCEND-5 Study
After about 16.5 months of treatment, the median progression-free survival was 5.4 months for people who took Zykadia compared to 1.6 months for the people who received chemotherapy. More people treated with Zykadia had a response than people who were treated with chemotherapy.
Your results may be different from what was seen in the studies.
What Can I Do to Prevent or Manage Side Effects of Zykadia?
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 Zykadia.
Sensitivity to sunlight (photosensitivity). Zykadia may cause your skin to be sensitive to sunlight, sunlamps, or tanning beds. You may get a severe sunburn from exposure to this light. To protect against sunburn, you should wear sunscreen, a hat, and clothing that covers your skin while you are taking Zykadia.
Stomach problems. You may have nausea, vomiting, diarrhea, or stomach pain while taking Zykadia. Eating small meals or snacks consisting of plain foods may help with nausea. Your health care provider may be able to recommend medicines to help with these side effects.
Shortness of breath. Call your health care provider or call 911 if you have sudden shortness of breath, as it can be a sign of a serious lung problem known as pneumonitis.
High blood sugar (hyperglycemia). Zykadia can increase blood sugar levels. Your health care provider will check your blood sugar and may ask you to monitor your blood sugar at home. Tell your health care provider if you have any symptoms of high blood sugar, such as hunger or thirst, peeing more than usual, or feeling weak or confused.
