Alunbrig (brigatinib) vs Retsevmo (selpercatinib)

Alunbrig (brigatinib) vs Retsevmo (selpercatinib)

Alunbrig (brigatinib) is an anaplastic lymphoma kinase (ALK) inhibitor indicated for the treatment of patients with ALK-positive metastatic non-small cell lung cancer (NSCLC) who have progressed on or are intolerant to crizotinib. Retsevmo (selpercatinib), on the other hand, is a selective RET kinase inhibitor used for the treatment of patients with NSCLC that is RET fusion-positive, as well as for certain types of thyroid cancer with RET alterations. When deciding between the two, it is crucial to have molecular testing to determine the presence of either ALK gene rearrangements or RET mutations in the tumor, as this will guide the choice of targeted therapy.

Difference between Alunbrig and Retsevmo

Metric Alunbrig (brigatinib) Retsevmo (selpercatinib)
Generic name Brigatinib Selpercatinib
Indications ALK-positive metastatic non-small cell lung cancer (NSCLC) RET-altered thyroid cancers and RET fusion-positive non-small cell lung cancer (NSCLC)
Mechanism of action ALK and EGFR inhibitor RET kinase inhibitor
Brand names Alunbrig Retsevmo
Administrative route Oral Oral
Side effects Nausea, diarrhea, fatigue, cough, headache Dry mouth, diarrhea, increased AST/ALT, hypertension, fatigue
Contraindications Hypersensitivity to brigatinib, severe hepatic impairment Hypersensitivity to selpercatinib, severe hepatic impairment
Drug class Tyrosine kinase inhibitor Tyrosine kinase inhibitor
Manufacturer Takeda Pharmaceuticals Eli Lilly and Company

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 lung cancer was demonstrated in clinical trials, where it showed significant activity in patients with ALK-positive NSCLC who had progressed on crizotinib, which is another ALK inhibitor. In a pivotal phase 2 trial, brigatinib displayed a high objective response rate and a median progression-free survival that was notably longer than what had been observed with crizotinib. Additionally, brigatinib has shown activity in the central nervous system, which is important as brain metastases are common in ALK-positive NSCLC patients.

Furthermore, the ALTA-1L trial, which is a phase 3 study, compared brigatinib to crizotinib in ALK-positive NSCLC patients who had not received prior ALK inhibitor treatment. Brigatinib significantly improved progression-free survival compared to crizotinib, underscoring its potency as a first-line treatment option for this patient population. The trial also indicated a lower incidence of brain metastases in patients treated with brigatinib, suggesting a potential protective effect against central nervous system involvement.

Retsevmo (selpercatinib) Efficacy in Lung Cancer

Retsevmo (selpercatinib) is another targeted therapy, which is specifically designed for the treatment of lung cancer harboring RET (rearranged during transfection) gene alterations. RET fusions are a rare driver in non-small cell lung cancer, and selpercatinib has been shown to be highly effective in this subset of patients. In the phase 1/2 LIBRETTO-001 trial, selpercatinib demonstrated a high objective response rate in patients with RET fusion-positive NSCLC who were previously treated with platinum-based chemotherapy. The treatment also resulted in durable responses, with many patients experiencing prolonged disease control.

In addition to its efficacy in previously treated patients, selpercatinib has also been evaluated as a first-line therapy for RET fusion-positive NSCLC. The results from the same LIBRETTO-001 trial indicated that treatment-naive patients had an even higher response rate and longer progression-free survival, suggesting that selpercatinib may be particularly beneficial when used earlier in the treatment course. Given its targeted mechanism of action, selpercatinib is generally well-tolerated, with a manageable safety profile that supports its use in the clinical setting for patients with RET-altered lung cancers.

Regulatory Agency Approvals

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

Access Alunbrig or Retsevmo today

If Alunbrig or Retsevmo are not approved or available in your country (e.g. due to supply issues), you can access them via Everyone.org.

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