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  1. 1. Crizotinib (PF-02341066 ) c-MET inhibitor in Patient with Alk ( anaplastic lymphoma kinase ) -positive NSCLC <ul><li>MET is commonly overexpressed in lung cancer and its amplification may produce resistance to EGFR-TKI’s therapy </li></ul><ul><li>EML4 (Echinoderm Microtube associated protein Like4) Alk (Anaplastic lymphoma kinase) fusion frequency=4% adenocarcinoma (at least 7 fusion variants) </li></ul><ul><li>Crizotinib demonstrated potent growth inhibitory activity against H3122 (ALK fusion) cells </li></ul><ul><li>Patients with ALK -positive NSCLC Do not Appear to Respond to EGFR TKIs </li></ul>Inamura K et al. J Thorac Oncol 2008;3:13–17 Soda M et al. Proc Natl Acad Sci U S A 2008;105:19893–19897 Chiarle R et al. Nat Rev Cancer 2008;8(1):11–23; Mossé YP et al. Clin Cancer Res 2009;15(18):5609–5614 Shaw AT et al. J Clin Oncol 2009;27:4247–4253 ; Inversion Translocation OR Break-apart FISH assay for ALK -fusion genes Non-split signal Split signal
  2. 2. Available data with crizotinib <ul><li>Objective response rate (ORR): 57% (95% CI: 46, 68%) </li></ul><ul><ul><li>57% in patients with PS 2 or 3 </li></ul></ul><ul><li>Response duration: 1 to 15 months </li></ul><ul><li>Disease Control Rate (CR/PR/SD at 8 weeks): 87% </li></ul><ul><li>(95% CI: 77, 93%) </li></ul><ul><li>No grade 3 or 4 toxicities reported. 2% of grade 3 constipation and 1% grade 2 nausea, diarrhea and vomiting, respectively. 42% grade 1 visual disturbance (changes in light/dark accommodation, no abnormalities on ophthalmologic exam) </li></ul>ORR according to previous line therapies No. prior regimens* ORR % (n/N) 0 80 (4/5) 1 52 (14/27) 2 67 (10/15) ≥ 3 56 (19/34)
  3. 3. Current crizotinib clinical trials Available at: . NCT00890825 . <ul><li>Key entry criteria (N=318) </li></ul><ul><li>Positive for ALK by central laboratory </li></ul><ul><li>1 prior chemotherapy (platinum-based) </li></ul>PHASE III PHASE II <ul><li>Key entry criteria (N=250) </li></ul><ul><li>Positive for ALK by central laboratory </li></ul><ul><li>Progressive disease in Arm B of study A8081007 </li></ul><ul><li>>1 prior chemotherapy </li></ul><ul><ul><ul><li>Crizotinib 250 mg BID </li></ul></ul></ul><ul><li>Pemetrexed 500 mg/m 2 or </li></ul><ul><ul><ul><li>Docetaxel 75 mg/m 2 </li></ul></ul></ul><ul><ul><ul><li>infused on day 1 of a 21-day cycle </li></ul></ul></ul>R <ul><ul><ul><li>Crizotinib 250 mg BID </li></ul></ul></ul>PHASE III <ul><li>Key entry criteria (N=344) </li></ul><ul><li>Positive non squamous carcinoma for ALK by central laboratory </li></ul><ul><li>Chemonaive patients </li></ul><ul><ul><ul><li>Crizotinib 250 mg BID </li></ul></ul></ul><ul><li>Pemetrexed 500 mg/m 2 </li></ul><ul><ul><ul><li>Cisplatin 75 mg/m 2 or Carboplatin AUC5or6 </li></ul></ul></ul><ul><ul><ul><li>infused on day 1 of a 21-day cycle </li></ul></ul></ul>R R <ul><li>Pemetrexed 500 mg/m 2 </li></ul><ul><ul><ul><li>Cisplatin 75 mg/m 2 or Carboplatin AUC5or6 </li></ul></ul></ul><ul><ul><ul><li>infused on day 1 of a 21-day cycle </li></ul></ul></ul>Primary Endpoint: PFS Primary Endpoint: PFS Primary Endpoint: ORR