Xalkori Objection Handling

Question 1

Now that there are 3 ALK inhibitors on the market, what is the most appropriate sequence of therapies for patients with ALK + mNSCLC?

Answer 1

• Having 3 ALK inhibitors available is great news for ALK + patients. The Xalkori data as well as the category 1 NCCN recommendation support the use of Xalkori as the 1L therapy in ALK+ mNSCLC
• Xalkori is the standard of care in first line ALK+ mNSCLC. The other ALK inhibitors are indicated following progression or intolerance to Xalkori.
• Transition ALK messaging idetail or simple story

Question 2

I heard the news about the J-Alex trial being stopped early. Should I think of using it in 1L?

Answer 2

I am aware that it was stopped early. This is a Japanese trial comparing ALECENSA and XALKORI in Japanese patient populations. I have no additional info about this trial or ALECENSA.
- Transition to detail.

Question 3

Can I use ALECENSA in 1L ALK+ mNSCLC in patients with initial brain mets?

Answer 3

• No head to head trials of Xalkori and Alecensa have read out.
• Patients with brain mets were included in our Phase 3 trials. Brain mets present or absent was a stratification factor when randomizing patients to receive either Xalkori or platinum doublet therapy. In fact 27% of patients in the 1L study presented with brain mets at baseline.
• Transition to first line efficacy

Question 4

If I choose to use Alecensa in 1L can I use Xalkori after?

Answer 4

• Xalkori is the standard of care in first line ALK+ mNSCLC. Data is not available regarding Xalkori use after Alecensa.
• It is important that the agent used in 1st line can be followed with effective subsequent lines of therapy. Alecensa and Zykadia are both indicated following progression on or intolerance to Xalkori based on patients that were previously treated with Xalkori
• Transition to efficacy