Abstract

Ceritinib is a selective anaplastic lymphoma kinase (ALK) inhibitor approved for the treatment of patients with unresectable advanced and/or recurrent ALK fusion gene-positive non-small cell lung cancer (NSCLC). As per the approval condition in Japan, this post-marketing surveillance (PMS) study evaluated the clinical safety (including adverse events [AEs], adverse drug reactions [ADRs] and priority investigation items) and efficacy (including ORR and PFS) of ceritinib in Japanese patients. Interim analysis was conducted ~ 2 years after the start of this non-interventional, multicentre, uncontrolled, open-label, special drug-use investigation and results are reported from March 28, 2016 to April 28, 2018. Each patient was followed up for 1 year. Most patients started treatment with 750 mg ceritinib. Safety profile was similar to that observed at the time of approval. No new AEs or ADRs with incidences higher than that at approval were identified. The rate of gastrointestinal ADRs (nausea, vomiting and diarrhoea) was 73.64%. Meaningful efficacy was observed in both post-crizotinib and post-alectinib settings, with ORR of 29.55% (95% CI 20.29–40.22) and disease control rate of 53.41% (95% CI 42.46–64.12). No concerns regarding the safety and efficacy of ceritinib were identified. No new measures, including modification of the PMS study protocol, are considered necessary.

Highlights

  • Ceritinib is a selective anaplastic lymphoma kinase (ALK) inhibitor approved for the treatment of patients with unresectable advanced and/or recurrent ALK fusion gene-positive non-small cell lung cancer (NSCLC)

  • Considering the limited number of Japanese patients enrolled in the clinical trials assessing the safety and efficacy of ceritinib, one of the conditions for approval of ceritinib in Japan was to conduct a post-marketing surveillance (PMS) study as part of the risk management plan in all patients treated with ceritinib

  • This PMS study reported the results of the clinical use of ceritinib in patients with ALK+ unresectable advanced/ recurrent NSCLC

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Summary

Introduction

Ceritinib is a selective anaplastic lymphoma kinase (ALK) inhibitor approved for the treatment of patients with unresectable advanced and/or recurrent ALK fusion gene-positive non-small cell lung cancer (NSCLC). As per the approval condition in Japan, this post-marketing surveillance (PMS) study evaluated the clinical safety (including adverse events [AEs], adverse drug reactions [ADRs] and priority investigation items) and efficacy (including ORR and PFS) of ceritinib in Japanese patients. Considering the limited number of Japanese patients enrolled in the clinical trials assessing the safety and efficacy of ceritinib, one of the conditions for approval of ceritinib in Japan was to conduct a post-marketing surveillance (PMS) study as part of the risk management plan in all patients treated with ceritinib. The objective of this study was to evaluate the clinical safety and efficacy of ceritinib in Japanese patients with ALK+ unresectable advanced/recurrent NSCLC and to identify any safety and efficacy issues in paediatric, elderly and pregnant patients and in patients with renal/hepatic impairment, interstitial lung disease or heart disease, if they were enrolled in the study

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