1 INDICATIONS AND USAGE
ALECENSA is indicated for the treatment of patients with anaplastic lymphoma kinase (ALK)-positive, metastatic non-small cell lung cancer (NSCLC) who have progressed on or are intolerant to crizotinib.
12 CLINICAL PHARMACOLOGY
12.1 Mechanism of Action
Alectinib is a tyrosine kinase inhibitor that targets ALK and RET. In nonclinical studies, alectinib inhibited ALK phosphorylation and ALK-mediated activation of the downstream signaling proteins STAT3 and AKT, and decreased tumor cell viability in multiple cell lines harboring ALK fusions, amplifications, or activating mutations. The major active metabolite of alectinib, M4, showed similar in vitro potency and activity. Alectinib and M4 demonstrated in vitro and in vivo activity against multiple mutant forms of the ALK enzyme, including some mutations identified in NSCLC tumors in patients who have progressed on crizotinib. In mouse models implanted with tumors carrying ALK fusions, administration of alectinib resulted in antitumor activity and prolonged survival, including in mouse models implanted intracranially with ALK-driven tumor cell lines.
12.3 Pharmacokinetics
Elimination
Metabolism: Alectinib is metabolized by CYP3A4 to its major active metabolite M4. The geometric mean metabolite/parent exposure ratio at steady-state is 0.40. M4 is subsequently metabolized by CYP3A4. Alectinib and M4 were the main circulating moieties in plasma, constituting 76% of the total radioactivity.
14 CLINICAL STUDIES
Patients with locally advanced or metastatic ALK-positive NSCLC, who have progressed on crizotinib, with documented ALK positive NSCLC based on an FDA-approved test, and ECOG PS of 0-2 were enrolled in both studies.
PATIENT INFORMATION
- What is ALECENSA?
ALECENSA is a prescription medicine used to treat people with non-small cell lung cancer (NSCLC) that.
1) has a certain type of abnormal anaplastic lymphoma kinase (ALK) gene, and
2) has spread to other parts of your body, and
3) who have taken the medicine crizotinib, but their NSCLC worsened or they cannot tolerate taking crizotinib.