Alunbrig

Drug Overview

Alunbrig (brigatinib; Takeda) is a dual anaplastic lymphoma kinase (ALK) and epidermal growth factor receptor (EGFR) inhibitor. In preclinical studies, Alunbrig showed potent activity against secondary ALK mutations responsible for resistance to first-generation ALK inhibitor Xalkori (crizotinib; Pfizer/Merck KGaA), including the L1196M gatekeeper mutation. While Alunbrig also showed activity against mutated EGFR and its analogous secondary gatekeeper mutation, T790M, the drug is primarily being developed for ALK-positive NSCLC non-small cell lung cancer.

Although Alunbrig’s later arrival on the market could initially prevent it from overcoming more established ALK inhibitors, the drug will still play an important role as an alternative option in later lines of treatment. Each ALK inhibitor has shown varying efficacy against the many mutations responsible for resistance; therefore, having multiple options will help to provide a tailored treatment for each patient. Takeda is also currently conducting a Phase III trial of the drug in the first-line setting in an effort to increase Alunbrig’s peak market share.