DR CARBONE: So this is a study that tested alectinib in patients who have resistance to crizotinib or intolerance. And it was a study in 47 patients. And the response rate was quite high in this population. Objective responses in 55% of those patients, and they also showed that the drug got into the CNS and had CNS responses in that setting. So this is another member of that next-generation ALK inhibitor that’s showing promise.

DR LOVE: What about tolerability?

DR CARBONE: So the tolerability was quite good as well. Thirty percent had some fatigue. Myalgia was seen in 17%, peripheral edema in 15%. But dose-limiting side effects were only recorded in 2 of the 47 patients.

DR LOVE: So what about GI side effects, as we’ve been talking about with ceritinib?

DR CARBONE: Really much lower GI side effects than ceritinib.

DR LOVE: So Corey, where do you see things heading with this agent? And if it were available, how would you utilize it, and with ceritinib available?

DR LANGER: If, off study, assuming both were available, alectinib versus ceritinib, I would probably preferentially use alectinib.

DR LOVE: For toxicity reasons?

DR LANGER: Strictly for toxicity.

DR SPIGEL: So I have not used alectinib. Every one of my colleagues says that they think it’s the easiest drug to give and perhaps, at least, the most efficacious drug. But it remains to be seen.

So the pivotal so-called ALEX study is a randomized Phase III study underway now. It’s a global trial comparing crizotinib versus alectinib in the first-line setting. That’ll be the first head-to-head data we have.