Alunbrig (brigatinib) vs Vizimpro (dacomitinib)

Alunbrig (brigatinib) and Vizimpro (dacomitinib) are both oral medications used in the treatment of non-small cell lung cancer (NSCLC) with specific genetic mutations. Alunbrig is specifically indicated for patients with anaplastic lymphoma kinase (ALK)-positive metastatic NSCLC and has shown effectiveness in patients who have progressed on or are intolerant to crizotinib, which is another ALK inhibitor. In contrast, Vizimpro is approved for the first-line treatment of patients with metastatic NSCLC with epidermal growth factor receptor (EGFR) exon 19 deletion or exon 21 L858R substitution mutations and is not an ALK inhibitor. When deciding between the two medications, it is crucial to determine the specific genetic alterations present in the cancer, as this will guide the choice of treatment. Additionally, the side effect profiles, dosing schedules, and potential interactions with other medications should be carefully considered in consultation with a healthcare provider.

Difference between Alunbrig and Vizimpro

Metric	Alunbrig (brigatinib)	Vizimpro (dacomitinib)
Generic name	Brigatinib	Dacomitinib
Indications	Non-small cell lung cancer (NSCLC) with ALK mutations	First-line treatment of patients with metastatic NSCLC with EGFR exon 19 deletion or exon 21 L858R substitution mutations
Mechanism of action	ALK and EGFR inhibitor	EGFR inhibitor
Brand names	Alunbrig	Vizimpro
Administrative route	Oral	Oral
Side effects	Nausea, diarrhea, fatigue, cough, headache	Diarrhea, rash, paronychia, stomatitis, decreased appetite
Contraindications	Hypersensitivity to brigatinib	Hypersensitivity to dacomitinib
Drug class	Tyrosine kinase inhibitor	Tyrosine kinase inhibitor
Manufacturer	Takeda Oncology	Pfizer

Efficacy

Alunbrig (brigatinib) Efficacy in Lung Cancer

Alunbrig (brigatinib) is a targeted therapy approved for the treatment of non-small cell lung cancer (NSCLC) with a specific genetic mutation known as anaplastic lymphoma kinase (ALK) positive. The efficacy of Alunbrig in treating ALK-positive NSCLC has been demonstrated in several clinical trials. One pivotal trial, the ALTA-1L study, showed that brigatinib significantly improved progression-free survival (PFS) compared to crizotinib, another ALK inhibitor, in patients with locally advanced or metastatic ALK-positive NSCLC who had not received prior ALK inhibitor therapy.

Patients treated with Alunbrig experienced a median PFS of approximately 24 months, which was notably longer than the 11 months observed in patients treated with crizotinib. Additionally, Alunbrig showed a higher overall response rate (ORR), indicating a greater proportion of patients experienced tumor shrinkage. The intracranial efficacy of brigatinib, which is particularly important for patients with brain metastases, was also highlighted as a significant benefit of the treatment.

Vizimpro (dacomitinib) Efficacy in Lung Cancer

Vizimpro (dacomitinib) is another targeted therapy designed for the first-line treatment of patients with metastatic NSCLC with epidermal growth factor receptor (EGFR) exon 19 deletion or exon 21 L858R substitution mutations. The efficacy of Vizimpro in this patient population was established in the ARCHER 1050 study, a phase III clinical trial comparing dacomitinib to gefitinib, a first-generation EGFR inhibitor. The study demonstrated that Vizimpro significantly improved PFS, with a median PFS of 14.7 months compared to 9.2 months in patients treated with gefitinib.

Moreover, Vizimpro showed an improvement in overall survival (OS) in the treatment of EGFR-mutant NSCLC. Patients receiving dacomitinib had a median OS of 34.1 months, compared to 26.8 months for those on gefitinib. The ORR for Vizimpro was also consistent with improved outcomes, with a higher percentage of patients achieving a response to the therapy. However, it is important to note that the treatment with Vizimpro is associated with a distinct side-effect profile that requires careful management.

Regulatory Agency Approvals

Alunbrig

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Pharmaceuticals and Medical Devices Agency (PMDA), Japan

Vizimpro

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA

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