ALCHEMIST: Bringing genomic discovery and targeted therapies to early‐stage lung cancer (original) (raw)

“…The disease free survival rate of 90 % at 2 years (97 % stage 1, 73 % stage 2, and 92 % stage 3) was considered superior to historical genotypematched controls; most recurrences happened over 12 months after stopping treatment [27]. ALCHEMIST is a phase III trial initiated in 2014 with the goal of exploring the role of molecularly targeted therapy in the adjuvant setting; unlike previous adjuvant trials, all patients will undergo centralized molecular testing prior to enrollment [28]. Resected tumor specimens will be tested for both ALK rearrangements and EGFR mutations; patients harboring one of these genetic alterations will then be referred into either the ALCHEMIST-ALK or ALCHEMIST-EGFR trials, where they will receive crizotinib or erlotinib vs. placebo, respectively, after completing standard adjuvant chemotherapy.…”

Section: First-generation Egfr Inhibitorsmentioning

“…The disease free survival rate of 90 % at 2 years (97 % stage 1, 73 % stage 2, and 92 % stage 3) was considered superior to historical genotypematched controls; most recurrences happened over 12 months after stopping treatment [27]. ALCHEMIST is a phase III trial initiated in 2014 with the goal of exploring the role of molecularly targeted therapy in the adjuvant setting; unlike previous adjuvant trials, all patients will undergo centralized molecular testing prior to enrollment [28]. Resected tumor specimens will be tested for both ALK rearrangements and EGFR mutations; patients harboring one of these genetic alterations will then be referred into either the ALCHEMIST-ALK or ALCHEMIST-EGFR trials, where they will receive crizotinib or erlotinib vs. placebo, respectively, after completing standard adjuvant chemotherapy.…”

Section: First-generation Egfr Inhibitorsmentioning

“…Example umbrella trials include FOCUS4 [27], ALCHEMIST [28–29], and LUNG-MAP [30–31]. Like the umbrella trial, a Bayesian marker-adaptive design (Figure 1f) may include multiple therapies and molecular subgroups.…”

Section: Biomarker-based Designs Overviewmentioning

“…Duration of treatment with targeted therapies will be up to 2 years. Planned enrollment for these trials are 410 and 378 patients, respectively, with OS as a primary endpoint (80).…”

Section: Role Of Targeted and Immune Therapies In Earlier Stagesmentioning