Introduction

Brigatinib (trade name: Alunbrig) has been approved in Germany since November 2018 for the treatment of advanced non-small-cell lung lung cancer in adults. It can be used in patients who have certain mutated cancer cells that can lead to faster tumor growth. These patients should also have already had treatment with crizotinib.

Lung cancer is caused by the malignant growth of cells in the airways (bronchi). It is also referred to as a bronchogenic carcinoma. There are two main types of lung cancer:

  • Small-cell lung carcinoma (SCLC)
  • Non-small-cell lung cancer (NSCLC)

NSCLC is surgically removed. But sometimes the tumor has already become too large or the cancer has spread to other parts of the body (metastasis) through the blood or lymphatic system. It is then called advanced lung cancer.

Some people with non-small-cell lung cancer have an abnormal enzyme in the tumor tissue called anaplastic lymphoma kinase (ALK). The full name of the cancer is then ALK-positive non-small-cell lung cancer. The enzyme ALK can lead to uncontrolled growth of the tumor tissue.

Brigatinib is used to try to block the ALK enzyme, thereby inhibiting further tumor growth.

Application

Brigatinib is available in the form of tablets, in the doses 30 mg, 90 mg and 180 mg.

For the first seven days the dose is 90 mg brigatinib. After that it is increased to 180 mg brigatinib.

Other treatments

The medicine ceritinib is a possible treatment option for people with ALK-positive non-small-cell lung cancer who have already had treatment with crizotinib.

Assessment

In 2019, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into the advantages and disadvantages of brigatinib compared with the standard treatment (ceritinib) in people with ALK-positive non-small-cell lung cancer who have already had treatment with crizotinib.

But the manufacturer didn’t provide any suitable data with which to do the assessment.

More information

This information summarizes the main results of a review produced by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany). The review was commissioned by the German Federal Joint Committee (G-BA) as part of the “early benefit assessment of medications.” On the basis of the review and the hearings received, the G-BA passed a resolution on the added benefit of brigatinib (Alunbrig).