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Alectinib CNS ALK — SCE Medical Oncology MCQ

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ModerateLung CancerAlectinib CNS ALKSCE Medical Oncology

A 55-year-old woman with ALK+ NSCLC on alectinib develops a brain metastasis at 18 months. What makes alectinib suited for CNS disease?

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Correct answer: C — Alectinib has excellent CNS penetration and superior intracranial response rates vs crizotinib (~59% vs ~26% in ALEX trial)

ALEX trial: alectinib intracranial ORR ~59% vs crizotinib ~26%. Alectinib's CNS activity, alongside superior systemic PFS (34.8 vs 10.9 months), made it the preferred first-line ALK inhibitor.

Reference: NICE TA536 Alectinib; ALEX Peters et al NEJM 2017