Non-Small Cell Lung CancerPhase 3ALEXNCT02075840
A Study Comparing Alectinib With Crizotinib in Treatment-Naive Anaplastic Lymphoma Kinase-Positive Advanced Non-Small Cell Lung Cancer Participants
A Phase 3 study testing Alectinib and Crizotinib in people with Non-Small Cell Lung Cancer, run by Hoffmann-La Roche at 97 sites in 29 countries.
Trial summary
This randomized, active controlled, multicenter phase III open-label study is designed to evaluate the efficacy and safety of alectinib compared with crizotinib treatment in participants with treatment-naive anaplastic lymphoma kinase-positive (ALK-positive) advanced non-small cell lung cancer (NSCLC). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Non-Small Cell Lung Cancer
- What is being tested?
- Alectinib and Crizotinib
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 303 participants
- Where
- 97 sitesin 29 countries
- Study dates
- 19 Aug 2014to 28 Apr 2025
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Histologically or cytologically confirmed diagnosis of advanced or recurrent (Stage IIIB not amenable for multimodality treatment) or metastatic (Stage IV) NSCLC that is ALK-positive as assessed by the Ventana immunohistochemistry (IHC) test
- Life expectancy of at least 12 weeks
- Eastern cooperative oncology group performance status (ECOG PS) of 0-2
- Participants with no prior systemic treatment for advanced or recurrent (Stage IIIB not amenable for multimodality treatment) or metastatic (Stage IV) NSCLC
- Adequate renal, and hematologic function
- Participants must have recovered from effects of any major surgery or significant traumatic injury at least 28 days before the first dose of study treatment
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- Measurable disease by response evaluation criteria in solid tumors (RECIST) version 1.1 (v1.1) prior to the administration of study treatment
- Prior brain or leptomeningeal metastases allowed if asymptomatic (e.g., diagnosed incidentally at study baseline)
- Negative pregnancy test for all females of child bearing potential
- Use of highly effective contraception as defined by the study protocol
Who cannot join
- Participants with a previous malignancy within the past 3 years
- Any gastrointestinal (GI) disorder or liver disease
- National cancer institute common terminology criteria for adverse events (NCI CTCAE) (version 4.0) Grade 3 or higher toxicities due to any prior therapy (e.g., radiotherapy) (excluding alopecia)
- History of organ transplant
- Co-administration of anti-cancer therapies other than those administered in this study
- Participants with baseline QTc greater than (>) 470 milliseconds or symptomatic bradycardia
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- Recipient of strong/potent cytochrome P4503A inhibitors or inducers within 14 days prior to the first dose until the end of study treatment
- Recipient of any drug with potential QT interval prolonging effects within 14 days prior to the first dose for all participants and while on treatment through the end of the study for crizotinib-treated participants only
- History of hypersensitivity to any of the additives in the alectinib and crizotinib drug formulation
- Pregnancy or lactation
- Any clinically significant disease or condition (or history of) that could interfere with, or for which the treatment might interfere with, the conduct of the study or the absorption of oral medications or that would, in the opinion of the principal investigator, pose an unacceptable risk to the participant in this study
- Any psychological, familial, sociological, or geographical condition potentially hampering compliance with the study protocol requirements and/or follow-up procedures; those conditions should be discussed with the participant before trial entry
Trial locations and contacts
97 sites in 29 countries.
97 sites in 29 countries
United States10 sites
University of Colorado Cancer Center
Aurora, Colorado, 80045
Beth Israel Deaconess Med Ctr
Boston, Massachusetts, 02215
Dana Farber Can Ins
Boston, Massachusetts, 02215
University of Miami-Deerfield Beach
Deerfield Beach, Florida, 33442
Karmanos Cancer Institute
Detroit, Michigan, 48201
University of Texas M.D. Anderson Cancer Center
Houston, Texas, 77030
SCRI Oncology Partners
Nashville, Tennessee, 37203
North Valley Hem Onc Med Grp
Northridge, California, 91325
TMPN/ Cancer Care Associates
Redondo Beach, California, 90277
Washington Uni School of Medicine
St Louis, Missouri, 63110
Italy9 sites
Irccs Ist. Tumori Giovanni Paolo Ii
Bari, Apulia, 70124
Az Ospedaliera Nuovo Garibaldi Quartiere Nesima
Catania, Sicily, 95122
Irccs Istituto Nazionale Dei Tumori (Int)
Milan, Lombardy, 20133
Irccs Istituto Europeo Di Oncologia (IEO)
Milan, Lombardy, 20141
Azienda Ospedaliero-Universitaria San Luigi Gonzaga
Orbassano, Piedmont, 10043
A.O. Universitaria Di Parma
Parma, Emilia-Romagna, 43100
Azienda Ospedaliera Di Perugia Ospedale s. Maria Della Misericordia
Perugia, Umbria, 06156
Ospedale Provinciale Santa Maria Delle Croci
Ravenna, Emilia-Romagna, 48100
Policlinico Umberto i di Roma
Rome, Lazio, 00161
South Korea6 sites
National Cancer Center
Gyeonggi-do, 10408
Seoul National University Bundang Hospital
Gyeonggi-do, 13620
Seoul National University Hospital
Seoul, 03080
Severance Hospital, Yonsei University Health System
Seoul, 03722
Asan Medical Center
Seoul, 05505
Samsung Medical Center
Seoul, 06351
Australia5 sites
Queen Elizabeth Hospital
Adelaide, South Australia, 5011
Kinghorn Cancer Centre
Darlinghurst, New South Wales, 2010
Royal North Shore Hospital
St Leonards, New South Wales, 2065
Monash Health Translational Precinct
Victoria, Victoria, 3168
Calvary Mater Newcastle
Waratah, New South Wales, 2298
Hong Kong5 sites
Tuen Mun Hospital
Hong Kong, 852
Pamela Youde Nethersole Eastern Hospital
Hong Kong, DUMMY_VALUE
Princess Margaret Hospital
Hong Kong, DUMMY_VALUE
Queen Mary Hospital
Hong Kong, DUMMY_VALUE
Prince of Wales Hosp
Hong Kong
Spain5 sites
Hospital General Univ. de Alicante
Alicante, 3010
Vall d'Hebron Institute of Oncology (VHIO), Barcelona
Barcelona, 08035
Hospital Universitari Germans Trias i Pujol
Barcelona, 08916
Hospital Universitario Puerta de Hierro
Madrid, 28222
Hospital Universitario Virgen del Rocio
Seville, 41013
Thailand5 sites
National Cancer Inst.
Bangkok, 10400
Chiang Rai Prachanukroh Hospital
Chiang Rai, 57000
Khonkaen Hospital
Khonkaen, 40000
King Chulalongkorn Memorial Hospital
Patumwan, 10330
Songklanagarind Hospital
Songkhla, 90110
Canada4 sites
Cross Cancer Institute
Edmonton, Alberta, T6G 1Z2
Saskatoon Cancer Centre
Saskatoon, Saskatchewan, S7N 4H4
Sunnybrook Odette Cancer Centre
Toronto, Ontario, M4N 3M5
Mount Sinai Hospital
Toronto, Ontario, M5G 1X5
France4 sites
Chu Grenoble - Hopital Albert Michallon
Grenoble, 38043
CHRU de Lille
Lille, 59037
Centre Leon Berard
Lyon, 69373
Hopital Haut Leveque
Pessac, 33604
Poland4 sites
Uniwersyteckie Centrum Kliniczne
Gda?sk, 80-214
Ms Clinsearch Specjalistyczny Niepubliczny Zaklad Opieki Zdrowotnej
Lublin, 20-064
Warminsko-Mazurskie Centrum Chorób P?uc w Olsztynie
Olsztyn, 10-357
Centrum Onkologii - Inst.Im. Marii Sklodowskiej-Curie
Warsaw, 02-781
Russia4 sites
Moscow City Oncology Hospital #62
Moscovskaya Oblast, Moscow Oblast, 143423
N.N.Burdenko Main Military Clinical Hospital
Moscow, 105229
SPb City Clin Onc Dsp
Saint Petersburg, Sankt-Peterburg, 197022
Scientific Research Oncology Institute named after N.N. Petrov
Saint Petersburg, Sankt-Peterburg, 197758
Switzerland4 sites
Universitaetsspital Basel
Basel, 4031
Inselspital Bern
Bern, 3010
CHUV
Lausanne, 1011
UniversitätsSpital Zürich
Zurich, 8091
Taiwan4 sites
Taichung Veterans General Hospital
Taichung, 40705
National Cheng Kung Univ Hosp
Tainan, 00704
National Taiwan University Hospital
Taipei, 00100
Taipei Veterans General Hospital
Taipei, 00112
Turkey (Türkiye)4 sites
Baskent University Adana Dr. Turgut Noyan Practice and Research Hospital
Adana, 01250
Ankara University Medical Faculty
Ankara, 06100
Trakya University Medical Faculty Research And Practice Hospital Medical Oncology Department
Edirne, 22770
Inonu University Medical Faculty Turgut Ozal Medical Center Medical Oncology Department
Malatya, 44280
Portugal3 sites
CHUC - Unidade de Pneumologia Oncológica
Coimbra, 3000-075
IPO de Lisboa
Lisbon, 1099-023
IPO do Porto
Porto, 4200-072
United Kingdom3 sites
Birmingham Heartlands Hospital
Birmingham, B9 5SS
University College London Hospital
London, NW1 - 2PG
Guys & St Thomas Hospital
London, SE1 9RT
China2 sites
Sun Yet-sen University Cancer Center
Guangzhou, 510060
Shanghai Pulmonary Hospital
Shanghai, 200433
Israel2 sites
Rambam Medical Center
Haifa, 4959381
Meir Medical Center
Kfar Saba, 44281
Serbia2 sites
Clinical Center of Serbia
Belgrade, 11000
Institute for pulmonary diseases of Vojvodina
Kamenitz, 21204
Singapore2 sites
National University Hospital
Singapore, 119228
National Cancer Centre
Singapore, 169610
Ukraine2 sites
Kyiv Regional Oncological Dispensary
Kyiv, 04107
Lviv State Oncology Regional Treatment and Diagnostic Centre
Lviv, 79031
Bosnia and Herzegovina1 site
University Clinical Center Sarajevo
Sarajevo, 71000
Brazil1 site
Instituto do Cancer do Estado de Sao Paulo - ICESP
São Paulo, São Paulo, 01246-000
Mexico1 site
Instituto Nacional De Enfermedades Respiratorias
Mexico City, Mexico CITY (federal District), 14080
About this study
Official title: Randomized, Multicenter, Phase III, Open-Label Study of Alectinib Versus Crizotinib in Treatment-Naive Anaplastic Lymphoma Kinase-Positive Advanced Non-Small Cell Lung Cancer
This randomized, active controlled, multicenter phase III open-label study is designed to evaluate the efficacy and safety of alectinib compared with crizotinib treatment in participants with treatment-naive anaplastic lymphoma kinase-positive (ALK-positive) advanced non-small cell lung cancer (NSCLC). Participants will be randomized in a 1:1 ratio to receive either alectinib, 600 milligrams (mg) orally twice daily (BID), or crizotinib, 250 mg orally BID. Participants will receive treatment until disease progression, unacceptable toxicity, withdrawal of consent, or death. The study is expected to last approximately 144 months.
- Conditions
- Non-Small Cell Lung Cancer
- Being tested
- Alectinib, Crizotinib
- Medical subject headings
- Carcinoma, Non-Small-Cell Lung
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AlectinibDrug
Also called RO5424802
Participants will receive alectinib 600 mg orally (four 150 mg capsules) BID from Visit 0 (baseline) until disease progression, unacceptable toxicity, withdrawal of consent or death.
CrizotinibDrug
Participants will receive crizotinib 250 mg capsules orally BID from Visit 0 (baseline) until disease progression, unacceptable toxicity, withdrawal of consent or death.
| Study group | Role | What they receive |
|---|---|---|
| Alectinib | Experimental | Participants will receive alectinib from Visit 0 (baseline) until disease progression, unacceptable toxicity, withdrawal of consent or death. Receives: Drug: Alectinib |
| Crizotinib | Active comparator | Participants will receive crizotinib from Visit 0 (baseline) until disease progression, unacceptable toxicity, withdrawal of consent or death. Receives: Drug: Crizotinib |
What is being measured
The primary outcome is the main question the study is designed to answer.
Progression-Free Survival (PFS) by Investigator Assessment
PFS was assessed as time to disease progression or death whichever occurred first by investigator assessment using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 (v1.1) Criteria. As per RECIST v1.1, disease progression is a 20% increase in the sum of the diameters of target lesions, an increase in size of measurable lesions by at least 5 millimeter (mm) and the appearance of new lesions.
Measured: Randomization to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to 33 months)
Percentage of Participants With PFS Event by Investigator Assessment
PFS was assessed percentage of participants with disease progression or death whichever occurred first by investigator assessment using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 (v1.1) Criteria. As per RECIST v1.1, disease progression is a 20% increase in the sum of the diameters of target lesions, an increase in size of measurable lesions by at least 5 millimeter (mm) and the appearance of new lesions.
Measured: Randomization to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to 33 months)
Secondary outcomes (26)
PFS Independent Review Committee (IRC)-Assessed
PFS was assessed as time to disease progression or death whichever occurred first by IRC assessment using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 (v1.1) Criteria. As per RECIST v1.1, disease progression is a 20% increase in the sum of the diameters of target lesions, an increase in size of measurable lesions by at least 5 mm and the appearance of new lesions.
Measured: Randomization to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to 33 months)
Percentage of Participants With PFS Event by IRC
PFS was assessed as percentage of participants with disease progression or death whichever occurred first by IRC assessment using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 (v1.1) Criteria. As per RECIST v1.1, disease progression is a 20% increase in the sum of the diameters of target lesions, an increase in size of measurable lesions by at least 5 mm and the appearance of new lesions.
Measured: Randomization to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to 33 months)
Percentage of Participants With Central Nervous System (CNS) Progression as Determined by IRC Using RECIST V1.1 Criteria
CNS progression was assessed as percentage of participants with an event defined as time from randomization until first radiographic evidence of CNS progression by IRC. The risk for a CNS progression without a prior non-CNS progression with alectinib compared with crizotinib.
Measured: Randomization to CNS PD as first occurrence of disease progression (assessed every 8 weeks up to 33 months)
Percentage of Participants With Central Nervous System (CNS) Progression as Determined by IRC Using Revised Assessment in Neuro Oncology (RANO) Criteria
CNS progression was assessed as percentage of participants with event defined as time from randomization until first radiographic evidence of CNS progression by IRC. The risk for a CNS progression without a prior non-CNS progression with alectinib compared with crizotinib.
Measured: Randomization to the first occurrence of disease progression in the CNS (assessed every 8 weeks up to 33 months)
Percentage of Participants With Objective Response Rate (ORR) of Complete Response (CR) or Partial Response (PR) as Determined by The Investigators According to RECIST V1.1 Criteria
ORR was defined as the percentage of participants who attained CR or PR. As per RECIST v1.1, CR: Disappearance of all target lesions and any pathological lymph nodes (whether target or non-target) must have reduction in short axis to < 10 mm, PR: At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum of diameters.
Measured: Randomization to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to 33 months)
Duration of Response (DOR) According to RECIST V1.1 Criteria as Assessed by the Investigators
DOR was defined as the time from when response (CR or PR) was first documented to first documented disease progression or death, whichever occurred first. DOR was evaluated for participants who had a best overall response (BOR) of CR or PR.
Measured: First occurrence of objective response to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to approximately 10 years)
Overall Survival (OS)
Overall survival (OS) was defined as the time from randomization to death from any cause.
Measured: From randomization until death (up to 10.5 years)
Percentage of Participants With OS Event
Overall survival (OS) was defined as the time from randomization to death from any cause.
Measured: From randomization until death (up to 10.5 years)
Percentage of Participants With CNS ORR of CR or PR IRC-assessed According to RECIST v1.1 Criteria
CNS ORR was defined as the percentage of participants who attained CR or PR and had measurable/non-measurable CNS lesions at baseline. As per RECIST v1.1, CR: Disappearance of all target lesions and any pathological lymph nodes (whether target or non-target) must have reduction in short axis to < 10 mm, PR: At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum of diameters.
Measured: Randomization to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to 33 months)
CNS DOR IRC-assessed According to RECIST v1.1 Criteria
CNS DOR was defined as the time from when response (CR or PR) was first documented to first documented disease progression or death, whichever occurred first. DOR was evaluated for participants who had a best overall response (BOR) of CR or PR.
Measured: First occurrence of CNS objective response to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to 33 months)
Percentage of Participants With Adverse Events
An adverse event (AE) is any untoward medical occurrence in a participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product.
Measured: Baseline up to approximately 10 years
Area Under The Concentration-Time Curve (AUC) of Alectinib
Measured: Pre-dose (within 2 hours before alectinib) (baseline), 1, 2, 4, 6, and 8 hours post-dose at Visit 0 (first dosing day) and Week 4; Pre-dose (within 2 hours) at Week 8, then every 8 weeks until disease progression or death/withdrawal (up to 33 months)
Maximum Concentration (Cmax) of Alectinib
Measured: Pre-dose (within 2 hours before alectinib), 1, 2, 4, 6, and 8 hours post-dose at baseline and Week 4; Pre-dose (within 2 hours before alectinib) at Week 8, then every 8 weeks until disease progression or death/withdrawal from study (up to 33 months)
Time to Reach Cmax (Tmax) of Alectinib
Measured: Pre-dose (within 2 hours before alectinib), 1, 2, 4, 6, and 8 hours post-dose at baseline and Week 4; Pre-dose (within 2 hours before alectinib) at Week 8, then every 8 weeks until disease progression or death/withdrawal from study (up to 33 months)
AUC of Alectinib Metabolite
Measured: Pre-dose (within 2 hours before alectinib) (baseline), 1, 2, 4, 6, and 8 hours post-dose at Visit 0 (first dosing day) and Week 4; Pre-dose (within 2 hours) at Week 8, then every 8 weeks until disease progression or death/withdrawal (up to 33 months)
Cmax of Alectinib Metabolite
Measured: Pre-dose (within 2 hours before alectinib), 1, 2, 4, 6, and 8 hours post-dose at baseline and Week 4; Pre-dose (within 2 hours before alectinib) at Week 8, then every 8 weeks until disease progression or death/withdrawal from study (up to 33 months)
Tmax of Alectinib Metabolite
Measured: Pre-dose (within 2 hours before alectinib), 1, 2, 4, 6, and 8 hours post-dose at baseline and Week 4; Pre-dose (within 2 hours before alectinib) at Week 8, then every 8 weeks until disease progression or death/withdrawal from study (up to 33 months)
Time to Deterioration by European Organization for The Research And Treatment of Cancer (EORTC) Quality Of Life Questionnaire Core 30 (C30)
The EORTC QLQ-30 module generated one multiple-item scale score assessing dyspnea and a series of single item scores assessing chest pain, arm/shoulder pain, pain in other parts, coughing, sore mouth, dysphagia, peripheral neuropathy, alopecia, and hemoptysis. All the scales and single-item scores were linearly transformed so that each score ranged from 0 to 100. A higher score on the global health and functioning subscales is indicative of better functioning. Confirmed clinically meaningful deterioration in global health status or function is defined as a >or=10-point decrease from baseline in a symptom score that must be held for at least two consecutive assessments or an initial >or=10-point decrease from baseline followed by death within 5 weeks from the last assessment.
Measured: Baseline, every 4 weeks until disease progression (up to 33 months)
Percentage of Participants With Deterioration by EORTC Quality Of Life Questionnaire Core 30 (C30)
The EORTC QLQ-30 module generated one multiple-item scale score assessing dyspnea and a series of single item scores assessing chest pain, arm/shoulder pain, pain in other parts, coughing, sore mouth, dysphagia, peripheral neuropathy, alopecia, and hemoptysis. All the scales and single-item scores were linearly transformed so that each score ranged from 0 to 100. A higher score on the global health and functioning subscales is indicative of better functioning. Confirmed clinically meaningful deterioration in global health status or function is defined as a >or=10-point decrease from baseline in a symptom score that must be held for at least two consecutive assessments or an initial >or=10-point decrease from baseline followed by death within 5 weeks from the last assessment.
Measured: Baseline, every 4 weeks until disease progression (up to 33 months)
Time to Deterioration by EORTC Quality of Life Questionnaire Lung Cancer Module 13 (LC13)
The EORTC QLQ-LC13 module generated one multiple-item scale score assessing dyspnea and a series of single item scores assessing chest pain, arm/shoulder pain, pain in other parts, coughing, sore mouth, dysphagia, peripheral neuropathy, alopecia, and hemoptysis. All the scales and single-item scores were linearly transformed so that each score ranged from 0 to 100. A higher score on the global health and functioning subscales is indicative of better functioning. Confirmed clinically meaningful deterioration in lung cancer symptoms is defined as a >or=10-point increase from baseline in a symptom score that must be held for at least two consecutive assessments or an initial >or=10-point increase above baseline followed by death within 5 weeks from the last assessment.
Measured: Baseline, every 4 weeks until disease progression (up to 33 months)
Percentage of Participants With Deterioration by EORTC Quality of Life Questionnaire Lung Cancer Module 13 (LC13)
The EORTC QLQ-LC13 module generated one multiple-item scale score assessing dyspnea and a series of single item scores assessing chest pain, arm/shoulder pain, pain in other parts, coughing, sore mouth, dysphagia, peripheral neuropathy, alopecia, and hemoptysis. All the scales and single-item scores were linearly transformed so that each score ranged from 0 to 100. A higher score on the global health and functioning subscales is indicative of better functioning. Confirmed clinically meaningful deterioration in lung cancer symptoms is defined as a >or=10-point increase from baseline in a symptom score that must be held for at least two consecutive assessments or an initial >or=10-point increase above baseline followed by death within 5 weeks from the last assessment.
Measured: Baseline, every 4 weeks until disease progression (up to 33 months)
Health-Related Quality of Life (HRQoL) by EORTC Quality of Life Questionnaire C30 Score
The EORTC QLQ-C30 questionnaire consisted of 30 questions generating five functional scores (physical, role, cognitive, emotional, and social); a global health status/global quality of life scale score; three symptom scale scores (fatigue, pain, and nausea and vomiting); and six stand alone one-item scores that capture additional symptoms (dyspnea, appetite loss, sleep disturbance, constipation, and diarrhea) and perceived financial burden. All the scales and single-item scores were linearly transformed so that each score ranged from 0 to 100. A higher score on the global health and functioning subscales is indicative of better functioning.
Measured: Baseline, every 4 weeks until disease progression (up to 33 months)
HRQoL by EORTC Quality of Life Questionnaire LC13 Score Coughing
The EORTC QLQ-LC13 module generated one multiple-item scale score assessing dyspnea and a series of single item scores assessing chest pain, arm/shoulder pain, pain in other parts, coughing, sore mouth, dysphagia, peripheral neuropathy, alopecia, and hemoptysis. All the scales and single-item scores were linearly transformed so that each score ranged from 0 to 100. A higher score on the global health and functioning subscales is indicative of better functioning.
Measured: Baseline, every 4 weeks until disease progression (up to 33 months)
HRQoL by EORTC Quality of Life Questionnaire LC13 Score Dyspnoea
The EORTC QLQ-LC13 module generated one multiple-item scale score assessing dyspnea and a series of single item scores assessing chest pain, arm/shoulder pain, pain in other parts, coughing, sore mouth, dysphagia, peripheral neuropathy, alopecia, and hemoptysis. All the scales and single-item scores were linearly transformed so that each score ranged from 0 to 100. A higher score on the global health and functioning subscales is indicative of better functioning.
Measured: Baseline, every 4 weeks until disease progression (up to 33 months)
HRQoL by EORTC Quality of Life Questionnaire LC13 Score Pain in Chest
The EORTC QLQ-LC13 module generated one multiple-item scale score assessing dyspnea and a series of single item scores assessing chest pain, arm/shoulder pain, pain in other parts, coughing, sore mouth, dysphagia, peripheral neuropathy, alopecia, and hemoptysis. All the scales and single-item scores were linearly transformed so that each score ranged from 0 to 100. A higher score on the global health and functioning subscales is indicative of better functioning.
Measured: Baseline, every 4 weeks until disease progression (up to 33 months)
HRQoL by EORTC Quality of Life Questionnaire LC13 Score Pain in Arm and Shoulder
The EORTC QLQ-LC13 module generated one multiple-item scale score assessing dyspnea and a series of single item scores assessing chest pain, arm/shoulder pain, pain in other parts, coughing, sore mouth, dysphagia, peripheral neuropathy, alopecia, and hemoptysis. All the scales and single-item scores were linearly transformed so that each score ranged from 0 to 100. A higher score on the global health and functioning subscales is indicative of better functioning.
Measured: Baseline, every 4 weeks until disease progression (up to 33 months)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Mar 2014 (estimated)
- Study start19 Aug 2014
- Primary completion9 Feb 2017
- Study completion28 Apr 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (7)Papers the sponsor has linked to this study.
- Other trials for Non-Small Cell Lung CancerStudies of the same condition, open and under way.
- More trials run by Hoffmann-La RocheThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 303 participants (actual)
Sponsor and investigators
- Lead sponsor
- Hoffmann-La Roche
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Clinical Trials, Study director, Hoffmann-La Roche
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02075840
- Sponsor's protocol ID
- BO28984
- Other IDs
- 2013-004133-33
- Acronym
- ALEX
- Status last verified
- May 2026
- First submitted
- 27 Feb 2014
- Last updated
- 29 May 2026
- Results posted
- Yes, on ClinicalTrials.gov
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Sikkema BJ, Baart SJ, Paats MS, Smit EF, Schols AMWJ, Mathijssen RHJ, van Rossum EFC, Dingemans AC. Body Weight Gain Associated With Alectinib in Patients With ALK+ Non-Small Cell Lung Cancer: Pooled Analysis of Individual Patient Data From Four Prospective Clinical Trials. J Clin Oncol. 2025 Feb 20;43(6):641-650. doi: 10.1200/JCO-24-01579. Epub 2024 Dec 11.
PubMed 39661917Dziadziuszko R, Peters S, Mok T, Camidge DR, Gadgeel SM, Ou SI, Konopa K, Noe J, Nowicka M, Bordogna W, Morcos PN, Smoljanovic V, Shaw AT. Circulating Cell-free DNA as a Prognostic Biomarker in Patients with Advanced ALK+ Non-small Cell Lung Cancer in the Global Phase III ALEX Trial. Clin Cancer Res. 2022 May 2;28(9):1800-1808. doi: 10.1158/1078-0432.CCR-21-2840.
PubMed 35275991Mok T, Camidge DR, Gadgeel SM, Rosell R, Dziadziuszko R, Kim DW, Perol M, Ou SI, Ahn JS, Shaw AT, Bordogna W, Smoljanovic V, Hilton M, Ruf T, Noe J, Peters S. Updated overall survival and final progression-free survival data for patients with treatment-naive advanced ALK-positive non-small-cell lung cancer in the ALEX study. Ann Oncol. 2020 Aug;31(8):1056-1064. doi: 10.1016/j.annonc.2020.04.478. Epub 2020 May 11.
PubMed 32418886Gadgeel S, Peters S, Mok T, Shaw AT, Kim DW, Ou SI, Perol M, Wrona A, Novello S, Rosell R, Zeaiter A, Liu T, Nuesch E, Balas B, Camidge DR. Alectinib versus crizotinib in treatment-naive anaplastic lymphoma kinase-positive (ALK+) non-small-cell lung cancer: CNS efficacy results from the ALEX study. Ann Oncol. 2018 Nov 1;29(11):2214-2222. doi: 10.1093/annonc/mdy405.
PubMed 30215676Burudpakdee C, Wong W, Seetasith A, Corvino FA, Yeh W, Gubens M. Economic impact of preventing brain metastases with alectinib in ALK-positive non-small cell lung cancer. Lung Cancer. 2018 May;119:103-111. doi: 10.1016/j.lungcan.2018.03.008. Epub 2018 Mar 9.
PubMed 29656744Peters S, Camidge DR, Shaw AT, Gadgeel S, Ahn JS, Kim DW, Ou SI, Perol M, Dziadziuszko R, Rosell R, Zeaiter A, Mitry E, Golding S, Balas B, Noe J, Morcos PN, Mok T; ALEX Trial Investigators. Alectinib versus Crizotinib in Untreated ALK-Positive Non-Small-Cell Lung Cancer. N Engl J Med. 2017 Aug 31;377(9):829-838. doi: 10.1056/NEJMoa1704795. Epub 2017 Jun 6.
PubMed 28586279Gainor JF, Shaw AT. J-ALEX: alectinib versus crizotinib in ALK-positive lung cancer. Lancet. 2017 Jul 1;390(10089):3-4. doi: 10.1016/S0140-6736(17)31074-7. Epub 2017 May 10. No abstract available.
PubMed 28501139
Study at a glance
From the registry record, last updated by the sponsor on 29 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Randomized, Multicenter, Phase III, Open-Label Study of Alectinib Versus Crizotinib in Treatment-Naive Anaplastic Lymphoma Kinase-Positive Advanced Non-Small Cell Lung Cancer
- ClinicalTrials.gov ID
- NCT02075840
- Acronym / sponsor ID
- ALEX / BO28984
- Conditions
- Non-Small Cell Lung Cancer
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 303 participants (actual)
- Lead sponsor
- Hoffmann-La RocheIndustry (pharma, biotech, devices)
- Study start
- 19 Aug 2014 (actual)
- Primary completion
- 9 Feb 2017 (actual)
- Study completion
- 28 Apr 2025 (actual)
- First posted
- 3 Mar 2014 (estimated)
- Results
- Posted 15 Mar 2018
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This randomized, active controlled, multicenter phase III open-label study is designed to evaluate the efficacy and safety of alectinib compared with crizotinib treatment in participants with treatment-naive anaplastic lymphoma kinase-positive (ALK-positive) advanced non-small cell lung cancer (NSCLC). Participants will be randomized in a 1:1 ratio to receive either alectinib, 600 milligrams (mg) orally twice daily (BID), or crizotinib, 250 mg orally BID. Participants will receive treatment until disease progression, unacceptable toxicity, withdrawal of consent, or death. The study is expected to last approximately 144 months.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Alectinib | Experimental | Drug: AlectinibParticipants will receive alectinib from Visit 0 (baseline) until disease progression, unacceptable toxicity, withdrawal of consent or death. |
| Crizotinib | Active comparator | Drug: CrizotinibParticipants will receive crizotinib from Visit 0 (baseline) until disease progression, unacceptable toxicity, withdrawal of consent or death. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (10 listed)
- Histologically or cytologically confirmed diagnosis of advanced or recurrent (Stage IIIB not amenable for multimodality treatment) or metastatic (Stage IV) NSCLC that is ALK-positive as assessed by the Ventana immunohistochemistry (IHC) test
- Life expectancy of at least 12 weeks
- Eastern cooperative oncology group performance status (ECOG PS) of 0-2
- Participants with no prior systemic treatment for advanced or recurrent (Stage IIIB not amenable for multimodality treatment) or metastatic (Stage IV) NSCLC
- Adequate renal, and hematologic function
Key exclusion criteria (12 listed)
- Participants with a previous malignancy within the past 3 years
- Any gastrointestinal (GI) disorder or liver disease
- National cancer institute common terminology criteria for adverse events (NCI CTCAE) (version 4.0) Grade 3 or higher toxicities due to any prior therapy (e.g., radiotherapy) (excluding alopecia)
- History of organ transplant
- Co-administration of anti-cancer therapies other than those administered in this study
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| AlectinibAlso: RO5424802Participants will receive alectinib 600 mg orally (four 150 mg capsules) BID from Visit 0 (baseline) until disease progression, unacceptable toxicity, withdrawal of consent or death. | Drug | Alectinib |
| CrizotinibParticipants will receive crizotinib 250 mg capsules orally BID from Visit 0 (baseline) until disease progression, unacceptable toxicity, withdrawal of consent or death. | Drug | Crizotinib |
Primary outcome
Progression-Free Survival (PFS) by Investigator Assessment
Time frame: Randomization to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to 33 months)
PFS was assessed as time to disease progression or death whichever occurred first by investigator assessment using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 (v1.1) Criteria. As per RECIST v1.1, disease progression is a 20% increase in the sum of the diameters of target lesions, an increase in size of measurable lesions by at least 5 millimeter (mm) and the appearance of new lesions.
Percentage of Participants With PFS Event by Investigator Assessment
Time frame: Randomization to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to 33 months)
PFS was assessed percentage of participants with disease progression or death whichever occurred first by investigator assessment using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 (v1.1) Criteria. As per RECIST v1.1, disease progression is a 20% increase in the sum of the diameters of target lesions, an increase in size of measurable lesions by at least 5 millimeter (mm) and the appearance of new lesions.
26 secondary outcomes
PFS Independent Review Committee (IRC)-Assessed
Time frame: Randomization to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to 33 months)
Percentage of Participants With PFS Event by IRC
Time frame: Randomization to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to 33 months)
Percentage of Participants With Central Nervous System (CNS) Progression as Determined by IRC Using RECIST V1.1 Criteria
Time frame: Randomization to CNS PD as first occurrence of disease progression (assessed every 8 weeks up to 33 months)
Percentage of Participants With Central Nervous System (CNS) Progression as Determined by IRC Using Revised Assessment in Neuro Oncology (RANO) Criteria
Time frame: Randomization to the first occurrence of disease progression in the CNS (assessed every 8 weeks up to 33 months)
Percentage of Participants With Objective Response Rate (ORR) of Complete Response (CR) or Partial Response (PR) as Determined by The Investigators According to RECIST V1.1 Criteria
Time frame: Randomization to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to 33 months)
Duration of Response (DOR) According to RECIST V1.1 Criteria as Assessed by the Investigators
Time frame: First occurrence of objective response to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to approximately 10 years)
Overall Survival (OS)
Time frame: From randomization until death (up to 10.5 years)
Percentage of Participants With OS Event
Time frame: From randomization until death (up to 10.5 years)
Percentage of Participants With CNS ORR of CR or PR IRC-assessed According to RECIST v1.1 Criteria
Time frame: Randomization to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to 33 months)
CNS DOR IRC-assessed According to RECIST v1.1 Criteria
Time frame: First occurrence of CNS objective response to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to 33 months)
Percentage of Participants With Adverse Events
Time frame: Baseline up to approximately 10 years
Area Under The Concentration-Time Curve (AUC) of Alectinib
Time frame: Pre-dose (within 2 hours before alectinib) (baseline), 1, 2, 4, 6, and 8 hours post-dose at Visit 0 (first dosing day) and Week 4; Pre-dose (within 2 hours) at Week 8, then every 8 weeks until disease progression or death/withdrawal (up to 33 months)
Maximum Concentration (Cmax) of Alectinib
Time frame: Pre-dose (within 2 hours before alectinib), 1, 2, 4, 6, and 8 hours post-dose at baseline and Week 4; Pre-dose (within 2 hours before alectinib) at Week 8, then every 8 weeks until disease progression or death/withdrawal from study (up to 33 months)
Time to Reach Cmax (Tmax) of Alectinib
Time frame: Pre-dose (within 2 hours before alectinib), 1, 2, 4, 6, and 8 hours post-dose at baseline and Week 4; Pre-dose (within 2 hours before alectinib) at Week 8, then every 8 weeks until disease progression or death/withdrawal from study (up to 33 months)
AUC of Alectinib Metabolite
Time frame: Pre-dose (within 2 hours before alectinib) (baseline), 1, 2, 4, 6, and 8 hours post-dose at Visit 0 (first dosing day) and Week 4; Pre-dose (within 2 hours) at Week 8, then every 8 weeks until disease progression or death/withdrawal (up to 33 months)
Cmax of Alectinib Metabolite
Time frame: Pre-dose (within 2 hours before alectinib), 1, 2, 4, 6, and 8 hours post-dose at baseline and Week 4; Pre-dose (within 2 hours before alectinib) at Week 8, then every 8 weeks until disease progression or death/withdrawal from study (up to 33 months)
Tmax of Alectinib Metabolite
Time frame: Pre-dose (within 2 hours before alectinib), 1, 2, 4, 6, and 8 hours post-dose at baseline and Week 4; Pre-dose (within 2 hours before alectinib) at Week 8, then every 8 weeks until disease progression or death/withdrawal from study (up to 33 months)
Time to Deterioration by European Organization for The Research And Treatment of Cancer (EORTC) Quality Of Life Questionnaire Core 30 (C30)
Time frame: Baseline, every 4 weeks until disease progression (up to 33 months)
Percentage of Participants With Deterioration by EORTC Quality Of Life Questionnaire Core 30 (C30)
Time frame: Baseline, every 4 weeks until disease progression (up to 33 months)
Time to Deterioration by EORTC Quality of Life Questionnaire Lung Cancer Module 13 (LC13)
Time frame: Baseline, every 4 weeks until disease progression (up to 33 months)
Percentage of Participants With Deterioration by EORTC Quality of Life Questionnaire Lung Cancer Module 13 (LC13)
Time frame: Baseline, every 4 weeks until disease progression (up to 33 months)
Health-Related Quality of Life (HRQoL) by EORTC Quality of Life Questionnaire C30 Score
Time frame: Baseline, every 4 weeks until disease progression (up to 33 months)
HRQoL by EORTC Quality of Life Questionnaire LC13 Score Coughing
Time frame: Baseline, every 4 weeks until disease progression (up to 33 months)
HRQoL by EORTC Quality of Life Questionnaire LC13 Score Dyspnoea
Time frame: Baseline, every 4 weeks until disease progression (up to 33 months)
HRQoL by EORTC Quality of Life Questionnaire LC13 Score Pain in Chest
Time frame: Baseline, every 4 weeks until disease progression (up to 33 months)
HRQoL by EORTC Quality of Life Questionnaire LC13 Score Pain in Arm and Shoulder
Time frame: Baseline, every 4 weeks until disease progression (up to 33 months)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 May 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 39661917Sikkema BJ, Baart SJ, Paats MS, Smit EF, Schols AMWJ, Mathijssen RHJ, van Rossum EFC, Dingemans AC. Body Weight Gain Associated With Alectinib in Patients With ALK+ Non-Small Cell Lung Cancer: Pooled Analysis of Individual Patient Data From Four Prospective Clinical Trials. J Clin Oncol. 2025 Feb 20;43(6):641-650. doi: 10.1200/JCO-24-01579. Epub 2024 Dec 11.
- Derived from this study: PubMed 35275991Dziadziuszko R, Peters S, Mok T, Camidge DR, Gadgeel SM, Ou SI, Konopa K, Noe J, Nowicka M, Bordogna W, Morcos PN, Smoljanovic V, Shaw AT. Circulating Cell-free DNA as a Prognostic Biomarker in Patients with Advanced ALK+ Non-small Cell Lung Cancer in the Global Phase III ALEX Trial. Clin Cancer Res. 2022 May 2;28(9):1800-1808. doi: 10.1158/1078-0432.CCR-21-2840.
- Derived from this study: PubMed 32418886Mok T, Camidge DR, Gadgeel SM, Rosell R, Dziadziuszko R, Kim DW, Perol M, Ou SI, Ahn JS, Shaw AT, Bordogna W, Smoljanovic V, Hilton M, Ruf T, Noe J, Peters S. Updated overall survival and final progression-free survival data for patients with treatment-naive advanced ALK-positive non-small-cell lung cancer in the ALEX study. Ann Oncol. 2020 Aug;31(8):1056-1064. doi: 10.1016/j.annonc.2020.04.478. Epub 2020 May 11.
- Derived from this study: PubMed 30215676Gadgeel S, Peters S, Mok T, Shaw AT, Kim DW, Ou SI, Perol M, Wrona A, Novello S, Rosell R, Zeaiter A, Liu T, Nuesch E, Balas B, Camidge DR. Alectinib versus crizotinib in treatment-naive anaplastic lymphoma kinase-positive (ALK+) non-small-cell lung cancer: CNS efficacy results from the ALEX study. Ann Oncol. 2018 Nov 1;29(11):2214-2222. doi: 10.1093/annonc/mdy405.
- Derived from this study: PubMed 29656744Burudpakdee C, Wong W, Seetasith A, Corvino FA, Yeh W, Gubens M. Economic impact of preventing brain metastases with alectinib in ALK-positive non-small cell lung cancer. Lung Cancer. 2018 May;119:103-111. doi: 10.1016/j.lungcan.2018.03.008. Epub 2018 Mar 9.
- Derived from this study: PubMed 28586279Peters S, Camidge DR, Shaw AT, Gadgeel S, Ahn JS, Kim DW, Ou SI, Perol M, Dziadziuszko R, Rosell R, Zeaiter A, Mitry E, Golding S, Balas B, Noe J, Morcos PN, Mok T; ALEX Trial Investigators. Alectinib versus Crizotinib in Untreated ALK-Positive Non-Small-Cell Lung Cancer. N Engl J Med. 2017 Aug 31;377(9):829-838. doi: 10.1056/NEJMoa1704795. Epub 2017 Jun 6.
- Derived from this study: PubMed 28501139Gainor JF, Shaw AT. J-ALEX: alectinib versus crizotinib in ALK-positive lung cancer. Lancet. 2017 Jul 1;390(10089):3-4. doi: 10.1016/S0140-6736(17)31074-7. Epub 2017 May 10. No abstract available.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Clinical Trials study director
Hoffmann-La Roche
97 sites in 29 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Alectinib and Crizotinib in people with Non-Small Cell Lung Cancer, run by Hoffmann-La Roche at 97 sites in 29 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 10 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 29 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 97 sites in United States, Italy, South Korea, Australia, Hong Kong and 24 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 15 Mar 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Progression-Free Survival (PFS) by Investigator Assessment (time frame: Randomization to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to 33 months)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02075840, which also lists 7 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 May 2026.