ALK-positive Advanced NSCLCPhase 2ALTA-2NCT03535740
A Study of Brigatinib in Participants With Anaplastic Lymphoma Kinase-Positive (ALK+), Advanced Non-Small-Cell Lung Cancer (NSCLC) Progressed on Alectinib or Ceritinib
A Phase 2 study testing Brigatinib in people with ALK-positive Advanced NSCLC, run by Ariad Pharmaceuticals at 80 sites in 15 countries.
Trial summary
The primary purpose of this study is to determine the efficacy of brigatinib by confirmed objective response rate (ORR) by response evaluation criteria in solid tumors (Response Evaluation Criteria in Solid Tumors [RECIST]), in participants with ALK+ locally advanced or metastatic NSCLC whose disease has progressed on… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- ALK-positive Advanced NSCLC
- What is being tested?
- Brigatinib
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 103 participants
- Where
- 80 sitesin 15 countries
- Study dates
- 31 Jan 2019to 21 Aug 2024
- Phase
- Phase 2
- 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
- Have histologically or cytologically confirmed stage IIIB (locally advanced or recurrent and not a participant for curative therapy) or stage IV non-small-cell lung cancer (NSCLC).
- Must meet both of the following 2 criteria:
- Have documentation of anaplastic lymphoma kinase (ALK) rearrangement by a positive result from any laboratory test® approved by the food and drug administration (FDA) or Have documented ALK rearrangement by a different test (non-FDA-approved local lab tests) and have provided tumor sample to the central laboratory. (Note: Central laboratory ALK rearrangement testing results are not required to be obtained before randomization.)
- Had been on any one of the ALK tyrosine kinase inhibitor (TKIs) (alectinib, ceritinib, crizotinib) for at least 12 weeks before progression.
- Had progressive disease (PD) while on alectinib or ceritinib
- Had alectinib or ceritinib as the most recent ALK inhibitor therapy.
Show all 9Show fewer
- Have at least 1 measurable lesion per response evaluation criteria in solid tumors (RECIST) version 1.1 as assessed by the investigator.
- Had recovered from toxicities related to prior anticancer therapy to national cancer institute common terminology criteria for adverse events (NCI CTCAE), version 4.03, Grade <=1. (Note: Treatment-related alopecia or peripheral neuropathy that are Grade >1 are allowed if deemed irreversible.) and have adequate major organ functions.
- Have a life expectancy of ≥3 months.
Who cannot join
- Had received any prior ALK-targeted TKI other than crizotinib, alectinib, or ceritinib.
- Had received both alectinib and ceritinib.
- Had previously received more than 3 regimens of systemic anticancer therapy for locally advanced or metastatic disease.
- Had symptomatic brain metastasis (parenchymal or leptomeningeal). Participants with asymptomatic brain metastasis or who have stable symptoms that did not require an increased dose of corticosteroids to control symptoms in the past 7 days before the first dose of brigatinib may be enrolled.
- Had current spinal cord compression (symptomatic or asymptomatic and detected by radiographic imaging). Participants with leptomeningeal disease and without cord compression are allowed.
- Had a cerebrovascular accident or transient ischemic attack within 6 months before first dose of brigatinib.
- Had an ongoing or active infection, including, but not limited to, the requirement for intravenous antibiotics.
- Had malabsorption syndrome or other gastrointestinal (GI) illness that could affect oral absorption of brigatinib.
Trial locations and contacts
80 sites in 15 countries.
80 sites in 15 countries
United States10 sites
Levine Cancer Institute - Southpark
Charlotte, North Carolina, 28211
Barbara Ann Karmanos Cancer Institute
Detroit, Michigan, 48201
USOR - Virginia Cancer Specialists - Fairfax Office
Fairfax, Virginia, 22031
Sarah Cannon Research Institute
Nashville, Tennessee, 37203
University of California Irvine Health Chao Family Comprehensive Cancer Center
Orange, California, 92868
Florida Hospital Medical Group
Orlando, Florida, 32804
Providence Portland Medical Center
Portland, Oregon, 97213
USOR - Rocky Mountain Cancer Centers - Pueblo
Pueblo, Colorado, 81008
Washington University School of Medicine
St Louis, Missouri, 63110
The Oncology Institute of Hope and Innovation
Whittier, California, 90602
South Korea9 sites
Chungbuk National University Hospital
Cheongju-si, Gyeongsangbuk-do, 28644
Keimyung University Dongsan Medical Center
Daegu, 41931
National Cancer Center
Goyang-si, Gyeonggi-do, 411-769
Gachon University Gil Medical Center
Incheon, Gyeonggi-do, 21565
Korea University Anam Hospital
Seoul, Gyeonggi-do, 02841
Seoul National University Hospital
Seoul, 03080
Severance Hospital
Seoul, 03722
Asan Medical Center
Seoul, 05505
Samsung Medical Center
Seoul, 135-710
Germany7 sites
HELIOS Klinikum Emil von Behring
Berlin, 14165
Evangelisches Krankenhaus Hamm
Hamm, North Rhine-Westphalia, 59063
Thoraxklinik Heidelberg gGmbH
Heidelberg, Baden-Wurttemberg, 69126
Klinikum Kempten-Oberallgau
Kempten (Allgäu), Bavaria, 87439
Ludwig-Maximilians-Universitat Munchen
München, Bavaria, 80336
Pius Hospital Oldenburg
Oldenburg, Lower Saxony, 26121
Universitatsklinikum Ulm
Ulm, Baden-Wurttemberg, 89081
Italy7 sites
Centro di Riferimento Oncologico di Aviano
Aviano, Pordenone, 33081
Istituto Europeo di Oncologia
Milan, 20141
Istituto Nazionale Tumori IRCCS Fondazione Pascale
Naples, 80131
Azienda Ospedaliero - Universitaria San Luigi Gonzaga
Orbassano, Torino, 10043
Azienda Ospedaliero Universitaria di Parma
Parma, 43126
Azienda USL della Romagna
Ravenna, 48121
Azienda Ospedaliera San Camillo Forlanini
Rome, Lazio, 00152
China6 sites
Beijing Cancer Hospital
Beijing, Beijing Municipality, 100000
Jilin Provincial Cancer Hospital (Changchun Cancer Hospital)
Changchun, Jilin, 130000
The First Affiliated Hospital of Guangzhou Medical University
Guangzhou, Guangdong, 510000
The First Affiliated Hospital of Zhejiang University School of Medicine
Hangzhou, Zhejiang, 310000
Zhejiang Cancer Hospital
Hangzhou, Zhejiang, 310000
Shanghai Pulmonary Hospital
Shanghai, Shanghai Municipality, 200001
Japan6 sites
Kansai Medical University Hirakata Hospital
Hirakata-shi, Osaka, 573-1191
The Cancer Institute Hospital of Japanese Foundation for Cancer Research
Koto-ku, Tokyo, 135-8550
Okayama University Hospital
Okayama, Okayama-ken, 700-8558
Sendai Kousei Hospital
Sendai, Miyagi, 980-0873
Fujita Health University Hospital
Toyoake, Aichi-ken, 470-1192
Kanagawa Cancer Center
Yokohama, Kanagawa, 241-8515
Spain6 sites
Complejo Hospitalario Universitario A Coruna
A Coruña, LA Coruna, 15006
Institut Catala d'Oncologia Badalona - Hospital Germans Trias i Pujol
Badalona, Barcelona, 08916
Hospital Universitario Vall d'Hebron
Barcelona, 08035
Hospital Universitario Ramon Y Cajal
Madrid, 28034
Hospital Universitario La Paz
Madrid, 28046
Hospital Universitario Puerta de Hierro - Majadahonda
Madrid, 28222
France5 sites
Centre Hospitalier Intercommunal de Creteil
Créteil, Île-de-France Region, 94010
Centre de Lutte Contre le Cancer Centre Leon Berard
Lyon, Auvergne-Rhône-Alpes, 69008
Assistance Publique-Hopitaux de Marseille Hopital Nord
Marseille, Provence-Alpes-Côte d'Azur Region, 13915
Hopital Haut-Leveque
Pessac, Aquitaine, 33604
Hopital Larrey, CHU de Toulouse, Service de Pneumologie
Toulouse, Midi-pyrenees, 31059
Hong Kong5 sites
Queen Mary Hospital
Hong Kong, 00852
Queen Mary Hospital
Hong Kong
Queen Elizabeth Hospital
Kowloon, 1076
Princess Margaret Hospital - Hong Kong
Kowloon
Prince of Wales Hospital
Shatin, New Territories
Canada4 sites
Tom Baker Cancer Center
Calgary, British Columbia, T2N 2T9
Cross Cancer Institute
Edmonton, Alberta, T6G 1Z2
McGill University Health Centre
Montreal, Quebec, H4A 3J1
Toronto University Health Network
Toronto, Ontario, M5G 2M9
Taiwan4 sites
Changhua Christian Hospital
Changhua, Changhwa, 500
China Medical University Hospital
Taichung, 404
Taichung Veterans General Hospital
Taichung, 40705
National Cheng Kung University
Tainan, Tainan CITY, 70403
Australia3 sites
Saint Vincent's Hospital Melbourne
Fitzroy, Victoria, 3065
Peninsula & South Eastern Haematology and Oncology Group
Frankston, Victoria, 3199
Sir Charles Gairdner Hospital
Nedlands, Western Australia, 6009
Netherlands3 sites
Vrije Universiteit Medisch Centrum
Amsterdam, North Holland, 1081 HV
Maastricht University Medical Centre
Maastricht, Limburg, 6229 HX
Erasmus University Medical Center
Rotterdam, South Holland, 3015 CE
Sweden3 sites
Skanes Universitetssjukhus i Lund
Lund, Skåne County, 214 01
Karolinska Universitetssjukhuset
Stockholm, 171 76
Uppsala Akademiska Sjukhus
Uppsala, 751 85
Austria2 sites
Klinikum Klagenfurt Am Worthersee
Klagenfurt, Carinthia, 9020
Krankenhaus Elisabethinen Linz
Linz, Upper Austria, 4020
About this study
Official title: Brigatinib in Patients With Anaplastic Lymphoma Kinase-Positive (ALK+), Advanced Non-Small-Cell Lung Cancer (NSCLC) Progressed on Alectinib or Ceritinib
The primary purpose of this study is to determine the efficacy of brigatinib by confirmed objective response rate (ORR) by response evaluation criteria in solid tumors (Response Evaluation Criteria in Solid Tumors [RECIST]), in participants with ALK+ locally advanced or metastatic NSCLC whose disease has progressed on therapy with alectinib or ceritinib.
Read the detailed description
The drug being tested in this study is called brigatinib (AP26113). Brigatinib is being tested to treat people who have anaplastic lymphoma kinase-positive (ALK+), advanced non-small-cell lung cancer (NSCLC).
The study will enroll approximately 103 patients. Participants will be assigned to the treatment group:
- Brigatinib
All participants will be asked to take brigatinib 90 mg tablet in lead-in period for 7 days, followed by brigatinib 180 mg at the same time each day throughout the study. Participants with progressive disease had an option to receive an escalated dose of brigatinib 240 mg as per investigator's discretion in case no toxicities (greater than grade 2) are experienced.
This multicenter trial will be conducted worldwide. The overall time to participate in this study is approximately 3 years. Participants will make multiple visits to the clinic, and 30 days after last dose of study drug for a follow-up assessment.
- Conditions
- ALK-positive Advanced NSCLC
- Being tested
- Brigatinib
- Keywords
- Drug Therapy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
BrigatinibDrug
Also called AP26113
Brigatinib Tablets
| Study group | Role | What they receive |
|---|---|---|
| Brigatinib 90 mg/180 mg With Optional Dose Escalation to 240 mg | Experimental | Brigatinib 90 mg, tablets, orally, once daily (QD) for 7 days, followed by brigatinib 180 mg, tablets, orally, QD for until objective disease progression per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, as assessed by the investigator, or intolerable toxicity. Participants who experienced progression on the 180 mg dose and had not experienced toxicities greater than Grade 2 had the option to receive brigatinib 240 mg QD based on investigator's discretion, up to 20 months until data cut-off: 30 September 2020. Participants who experienced progression on any doses but judged as still benefiting from the study treatment by the investigator may continue to use the current dose, up to study end. Receives: Drug: Brigatinib |
What is being measured
The primary outcome is the main question the study is designed to answer.
Confirmed Objective Response Rate (ORR) Using RECIST v1.1 as Assessed by the Independent Review Committee (IRC)
Confirmed ORR is defined as the percentage of the participants who are confirmed to have achieved complete response (CR) or partial response (PR), per RECIST version 1.1 (confirmed ≥4 weeks after initial response), after the initiation of study treatment. CR: disappearance of all extranodal target lesions and all pathological lymph nodes must have decreased to <10 mm in short axis and PR: at least a 30% decrease in the sum of the longest diameters (SLD) of target lesions taking as reference the Baseline sum diameters. Percentages were rounded off to the nearest single decimal place.
Measured: Up to approximately 20 months from the start of enrollment till data cut-off 30 September 2020
Secondary outcomes (12)
Confirmed ORR Using RECIST v1.1 as Assessed by the Investigator
Confirmed ORR is defined as the percentage of the participants who are confirmed to have achieved CR or PR, per RECIST version 1.1 (confirmed ≥4 weeks after initial response), after the initiation of study treatment. CR: disappearance of all extranodal target lesions and all pathological lymph nodes must have decreased to <10 mm in short axis and PR: at least a 30% decrease in the SLD of target lesions taking as reference the baseline sum diameters. Percentages were rounded off to the nearest single decimal place.
Measured: Up to approximately 28 months
Duration of Response (DOR) as Assessed by the IRC and the Investigator
DOR is defined as the time interval from the time that the measurement criteria are first met for CR or PR until the first date that the progressive disease (PD) is objectively documented, or death. CR: disappearance of all extranodal target lesions and all pathological lymph nodes must have decreased to <10 mm in short axis. PR: at least a 30% decrease in the SLD of target lesions taking as reference the Baseline sum diameters. PD: SLD increased by at least 20% from the smallest value on study (including Baseline, if that is the smallest). SLD must also demonstrate an absolute increase of at least 5 mm (2 lesions increasing from, for example, 2 mm to 3 mm, does not qualify).
Measured: Up to approximately 28 months
Progression-Free Survival (PFS) as Assessed by the IRC and the Investigator
PFS is defined as the time interval from the date of the first dose of the study treatment until the first date at which disease progression is objectively documented, or death due to any cause, whichever occurs first. PFS was censored for participants without documented disease progression or death.
Measured: Up to approximately 28 Months
Disease Control Rate (DCR) as Assessed by the IRC and the Investigator
DCR is defined as the percentage of participants who have achieved CR, PR or stable disease (SD) (in the case of SD, measurements must have met the SD criteria at least once after study entry at a minimum interval of 6 weeks) after the initiation of study treatment. CR: disappearance of all extranodal target lesions and all pathological lymph nodes must have decreased to <10 mm in short axis. PR: at least a 30% decrease in the SLD of target lesions taking as reference the baseline sum diameters. SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD. Percentages were rounded off to the nearest single decimal place.
Measured: Up to approximately 28 months
Time to Response as Assessed by the IRC and the Investigator
Time to response is defined as the time interval from the date of the first dose of the study treatment until the initial observation of CR or PR. CR: disappearance of all extranodal target lesions and all pathological lymph nodes must have decreased to <10 mm in short axis. PR: at least a 30% decrease in the SLD of target lesions taking as reference the baseline sum diameters.
Measured: Up to approximately 28 months
Confirmed Intracranial Objective Response Rate (iORR) in Participants With Brain Metastases at Baseline, as Assessed by the IRC
Confirmed iORR is defined as the percentage of the participants who have achieved CR or PR in the brain per a modification of RECIST version 1.1, after the initiation of study treatment, in participants with intracranial brain metastases at baseline. CR: disappearance of all extranodal target lesions and all pathological lymph nodes must have decreased to <10 mm in short axis. or partial response or PR: at least a 30% decrease in the SLD of target lesions taking as reference the baseline sum diameters. Percentages were rounded off to the nearest single decimal place.
Measured: Up to approximately 28 months
Duration of Intracranial Response in Participants With Brain Metastases at Baseline, as Assessed by the IRC
Duration of intracranial response is defined as the time interval from the time that the measurement criteria are first met for CR or PR until the first date that PD (including baseline, if that is the smallest). SLD must also demonstrate an absolute increase of at least 5 mm. (2 lesions increasing from, for example, 2 mm to 3 mm, does not qualify) in the brain is objectively documented or death, in participants with intracranial metastases at baseline. CR: disappearance of all extranodal target lesions and all pathological lymph nodes must have decreased to <10 mm in short axis. or partial response or PR: at least a 30% decrease in the SLD of target lesions taking as reference the baseline sum diameters in the brain. PD: SLD increased by at least 20% from the smallest value on study.
Measured: Up to approximately 28 months
Intracranial Progression-Free Survival (iPFS) in Participants With Brain Metastases at Baseline, as Assessed by the IRC
iPFS is defined as the time interval from the date of the first dose of the study treatment until the first date at which intracranial brain disease progression is objectively documented, or death due to any cause, whichever occurs first, in participants with intracranial metastases at enrollment. iPFS will be censored for participants without documented intracranial disease progression or death.
Measured: Up to approximately 28 months
Overall Survival (OS)
OS is defined as the time interval from the date of the first dose of the study treatment until death due to any cause. It was censored on the date of last contact for those participants who were alive.
Measured: Up to approximately 28 months
Number of Participants With One or More Treatment-emergent Adverse Event (TEAE)
An adverse event (AE) means any untoward medical occurrence in a participant administered a pharmaceutical product; the untoward medical occurrence does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product whether or not it is related to the medicinal product. This includes any newly occurring event, or a previous condition that has increased in severity or frequency since the administration of study drug. TEAE: any AE either reported for the first time or worsening of a pre-existing event after first dose of study drug and within 30 days of the last administration of study drug.
Measured: First dose of study drug up to 30 days after last dose (approximately 5 years)
Number of Participants With Improvement in Health-Related Quality of Life (HRQOL) Based on European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Score
EORTC QLQ-C30 incorporates 5 functional scales (physical functioning, role functioning, emotional functioning, cognitive functioning, and social functioning), 1 global health status scale, 3 symptom scales (fatigue, nausea and vomiting, and pain), and 6 single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). EORTC QLQ-C30 contains 28 questions (4-point scale where 1=Not at all [best] to 4=Very Much [worst]) and 2 questions (7-point scale where 1=Very poor [worst] to 7= Excellent [best]). Raw scores are converted into scale scores ranging from 0 to 100. For the functional scales and the global health status scale, higher scores represent better quality of life (QOL); for the symptom scales, lower scores represent better QOL. Improvement is defined as a change from baseline of 10 or more points higher for functional scales and 10 or more points lower for symptom scales.
Measured: Up to approximately 28 months
Number of Participants With Improvement of HRQOL Based on EORTC QLQ- Lung Cancer (LC) 13
HRQOL scores will be assessed with EORTC, its lung cancer module QLQ-LC13. QLQ-LC13 contains 13 questions assessing lung cancer-associated symptoms (cough, hemoptysis, dyspnea, and site-specific pain), treatment-related side effects (sore mouth, dysphagia, peripheral neuropathy, and alopecia), and use of pain medication. Scale score range: 0 to 100. Higher symptom score = greater degree of symptom severity. Improvement is defined as a change from baseline of 10 or more points lower for symptom scales.
Measured: Up to approximately 28 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 May 2018
- Study start31 Jan 2019
- Primary completion30 Sep 2020
- Study completion21 Aug 2024
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 (3)Papers the sponsor has linked to this study.
- Other trials for ALK-positive Advanced NSCLCStudies of the same condition, open and under way.
- 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 2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 103 participants (actual)
Sponsor and investigators
- Lead sponsor
- Ariad Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Takeda
- Responsible party
- Sponsor
- Investigators
- Medical Director, Study director, Takeda
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03535740
- Sponsor's protocol ID
- Brigatinib-2002
- Other IDs
- 2018-000635-27, NL66462.078.18, JapicCTI-194915, 2018
- Acronym
- ALTA-2
- Status last verified
- Jul 2025
- First submitted
- 9 May 2018
- Last updated
- 31 Jul 2025
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: Takeda provides access to the de-identified individual participant data (IPD) for eligible studies to aid qualified researchers in addressing legitimate scientific objectives (Takeda's data sharing commitment is available on https://clinicaltrials.takeda.com/takedas-commitment?commitment=5). These IPDs will be provided in a secure research environment following approval of a data sharing request, and under the terms of a data sharing agreement.
Publications
Mok T, Nishio M, Yoshida T, Ahn MJ, Kudou K, Asato T, Yang H, Tong X, Vincent S, Zhang P, Yamamoto N, Kim ES. Efficacy and safety of brigatinib after alectinib in patients with ALK-positive NSCLC: Integrated analysis of the ALTA-2 and J-ALTA studies. Lung Cancer. 2025 Nov;209:108793. doi: 10.1016/j.lungcan.2025.108793. Epub 2025 Oct 9.
PubMed 41110382Ou SI, Nishio M, Ahn MJ, Mok T, Barlesi F, Zhou C, Felip E, de Marinis F, Kim SW, Perol M, Liu G, Migliorino MR, Kim DW, Novello S, Bearz A, Garrido P, Mazieres J, Morabito A, Lin HM, Yang H, Niu H, Zhang P, Kim ES. Efficacy of Brigatinib in Patients With Advanced ALK-Positive NSCLC Who Progressed on Alectinib or Ceritinib: ALK in Lung Cancer Trial of brigAtinib-2 (ALTA-2). J Thorac Oncol. 2022 Dec;17(12):1404-1414. doi: 10.1016/j.jtho.2022.08.018. Epub 2022 Sep 10.
PubMed 36096442Kim ES, Barlesi F, Mok T, Ahn MJ, Shen J, Zhang P, Ou SI. ALTA-2: Phase II study of brigatinib in patients with ALK-positive, advanced non-small-cell lung cancer who progressed on alectinib or ceritinib. Future Oncol. 2021 May;17(14):1709-1719. doi: 10.2217/fon-2020-1119. Epub 2021 Feb 11.
PubMed 33569983
Study at a glance
From the registry record, last updated by the sponsor on 31 Jul 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Brigatinib in Patients With Anaplastic Lymphoma Kinase-Positive (ALK+), Advanced Non-Small-Cell Lung Cancer (NSCLC) Progressed on Alectinib or Ceritinib
- ClinicalTrials.gov ID
- NCT03535740
- Acronym / sponsor ID
- ALTA-2 / Brigatinib-2002
- Conditions
- ALK-positive Advanced NSCLC
- Keywords
- Drug Therapy
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 103 participants (actual)
- Lead sponsor
- Ariad PharmaceuticalsIndustry (pharma, biotech, devices)
- Collaborators
- Takeda
- Study start
- 31 Jan 2019 (actual)
- Primary completion
- 30 Sep 2020 (actual)
- Study completion
- 21 Aug 2024 (actual)
- First posted
- 24 May 2018 (actual)
- Results
- Posted 25 Oct 2021
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary purpose of this study is to determine the efficacy of brigatinib by confirmed objective response rate (ORR) by response evaluation criteria in solid tumors (Response Evaluation Criteria in Solid Tumors [RECIST]), in participants with ALK+ locally advanced or metastatic NSCLC whose disease has progressed on therapy with alectinib or ceritinib.
Detailed description
The drug being tested in this study is called brigatinib (AP26113). Brigatinib is being tested to treat people who have anaplastic lymphoma kinase-positive (ALK+), advanced non-small-cell lung cancer (NSCLC).
The study will enroll approximately 103 patients. Participants will be assigned to the treatment group:
- Brigatinib
All participants will be asked to take brigatinib 90 mg tablet in lead-in period for 7 days, followed by brigatinib 180 mg at the same time each day throughout the study. Participants with progressive disease had an option to receive an escalated dose of brigatinib 240 mg as per investigator's discretion in case no toxicities (greater than grade 2) are experienced.
This multicenter trial will be conducted worldwide. The overall time to participate in this study is approximately 3 years. Participants will make multiple visits to the clinic, and 30 days after last dose of study drug for a follow-up assessment.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Brigatinib 90 mg/180 mg With Optional Dose Escalation to 240 mg | Experimental | Drug: BrigatinibBrigatinib 90 mg, tablets, orally, once daily (QD) for 7 days, followed by brigatinib 180 mg, tablets, orally, QD for until objective disease progression per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, as assessed by the investigator, or intolerable toxicity. Participants who experienced progression on the 180 mg dose and had not experienced toxicities greater than Grade 2 had the option to receive brigatinib 240 mg QD based on investigator's discretion, up to 20 months until data cut-off: 30 September 2020. Participants who experienced progression on any doses but judged as still benefiting from the study treatment by the investigator may continue to use the current dose, up to study end. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (9 listed)
- Have histologically or cytologically confirmed stage IIIB (locally advanced or recurrent and not a participant for curative therapy) or stage IV non-small-cell lung cancer (NSCLC).
- Must meet both of the following 2 criteria:
- Had progressive disease (PD) while on alectinib or ceritinib
- Had alectinib or ceritinib as the most recent ALK inhibitor therapy.
- Have at least 1 measurable lesion per response evaluation criteria in solid tumors (RECIST) version 1.1 as assessed by the investigator.
Key exclusion criteria (8 listed)
- Had received any prior ALK-targeted TKI other than crizotinib, alectinib, or ceritinib.
- Had received both alectinib and ceritinib.
- Had previously received more than 3 regimens of systemic anticancer therapy for locally advanced or metastatic disease.
- Had symptomatic brain metastasis (parenchymal or leptomeningeal). Participants with asymptomatic brain metastasis or who have stable symptoms that did not require an increased dose of corticosteroids to control symptoms in the past 7 days before the first dose of brigatinib may be enrolled.
- Had current spinal cord compression (symptomatic or asymptomatic and detected by radiographic imaging). Participants with leptomeningeal disease and without cord compression are allowed.
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 |
|---|---|---|
| BrigatinibAlso: AP26113Brigatinib Tablets | Drug | Brigatinib 90 mg/180 mg With Optional Dose Escalation to 240 mg |
Primary outcome
Confirmed Objective Response Rate (ORR) Using RECIST v1.1 as Assessed by the Independent Review Committee (IRC)
Time frame: Up to approximately 20 months from the start of enrollment till data cut-off 30 September 2020
Confirmed ORR is defined as the percentage of the participants who are confirmed to have achieved complete response (CR) or partial response (PR), per RECIST version 1.1 (confirmed ≥4 weeks after initial response), after the initiation of study treatment. CR: disappearance of all extranodal target lesions and all pathological lymph nodes must have decreased to <10 mm in short axis and PR: at least a 30% decrease in the sum of the longest diameters (SLD) of target lesions taking as reference the Baseline sum diameters. Percentages were rounded off to the nearest single decimal place.
12 secondary outcomes
Confirmed ORR Using RECIST v1.1 as Assessed by the Investigator
Time frame: Up to approximately 28 months
Duration of Response (DOR) as Assessed by the IRC and the Investigator
Time frame: Up to approximately 28 months
Progression-Free Survival (PFS) as Assessed by the IRC and the Investigator
Time frame: Up to approximately 28 Months
Disease Control Rate (DCR) as Assessed by the IRC and the Investigator
Time frame: Up to approximately 28 months
Time to Response as Assessed by the IRC and the Investigator
Time frame: Up to approximately 28 months
Confirmed Intracranial Objective Response Rate (iORR) in Participants With Brain Metastases at Baseline, as Assessed by the IRC
Time frame: Up to approximately 28 months
Duration of Intracranial Response in Participants With Brain Metastases at Baseline, as Assessed by the IRC
Time frame: Up to approximately 28 months
Intracranial Progression-Free Survival (iPFS) in Participants With Brain Metastases at Baseline, as Assessed by the IRC
Time frame: Up to approximately 28 months
Overall Survival (OS)
Time frame: Up to approximately 28 months
Number of Participants With One or More Treatment-emergent Adverse Event (TEAE)
Time frame: First dose of study drug up to 30 days after last dose (approximately 5 years)
Number of Participants With Improvement in Health-Related Quality of Life (HRQOL) Based on European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Score
Time frame: Up to approximately 28 months
Number of Participants With Improvement of HRQOL Based on EORTC QLQ- Lung Cancer (LC) 13
Time frame: Up to approximately 28 months
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 31 Jul 2025.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 41110382Mok T, Nishio M, Yoshida T, Ahn MJ, Kudou K, Asato T, Yang H, Tong X, Vincent S, Zhang P, Yamamoto N, Kim ES. Efficacy and safety of brigatinib after alectinib in patients with ALK-positive NSCLC: Integrated analysis of the ALTA-2 and J-ALTA studies. Lung Cancer. 2025 Nov;209:108793. doi: 10.1016/j.lungcan.2025.108793. Epub 2025 Oct 9.
- Derived from this study: PubMed 36096442Ou SI, Nishio M, Ahn MJ, Mok T, Barlesi F, Zhou C, Felip E, de Marinis F, Kim SW, Perol M, Liu G, Migliorino MR, Kim DW, Novello S, Bearz A, Garrido P, Mazieres J, Morabito A, Lin HM, Yang H, Niu H, Zhang P, Kim ES. Efficacy of Brigatinib in Patients With Advanced ALK-Positive NSCLC Who Progressed on Alectinib or Ceritinib: ALK in Lung Cancer Trial of brigAtinib-2 (ALTA-2). J Thorac Oncol. 2022 Dec;17(12):1404-1414. doi: 10.1016/j.jtho.2022.08.018. Epub 2022 Sep 10.
- Derived from this study: PubMed 33569983Kim ES, Barlesi F, Mok T, Ahn MJ, Shen J, Zhang P, Ou SI. ALTA-2: Phase II study of brigatinib in patients with ALK-positive, advanced non-small-cell lung cancer who progressed on alectinib or ceritinib. Future Oncol. 2021 May;17(14):1709-1719. doi: 10.2217/fon-2020-1119. Epub 2021 Feb 11.
- Individual participant dataSharing planned: Yes. Takeda provides access to the de-identified individual participant data (IPD) for eligible studies to aid qualified researchers in addressing legitimate scientific objectives (Takeda's data sharing commitment is available on https://clinicaltrials.takeda.com/takedas-commitment?commitment=5). These IPDs will be provided in a secure research environment following approval of a data sharing request, and under the terms of a data sharing agreement.
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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.
Medical Director study director
Takeda
80 sites in 15 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Brigatinib in people with ALK-positive Advanced NSCLC, run by Ariad Pharmaceuticals at 80 sites in 15 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 9 inclusion and 8 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 31 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 80 sites in United States, South Korea, Germany, Italy, China and 10 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
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 25 Oct 2021). 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?
Confirmed Objective Response Rate (ORR) Using RECIST v1.1 as Assessed by the Independent Review Committee (IRC) (time frame: Up to approximately 20 months from the start of enrollment till data cut-off 30 September 2020). 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 NCT03535740, which also lists 3 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 31 Jul 2025.