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Last Updated: March 27, 2026

CLINICAL TRIALS PROFILE FOR ALECENSA


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All Clinical Trials for ALECENSA

Trial ID Title Status Sponsor Phase Start Date Summary
NCT02013219 ↗ A Phase 1b Study of Atezolizumab in Combination With Erlotinib or Alectinib in Participants With Non-Small Cell Lung Cancer (NSCLC) Completed Hoffmann-La Roche Phase 1 2014-04-03 This open-label, multicenter study will assess the safety, tolerability, and pharmacokinetics of intravenous (IV) dosing of atezolizumab in combination with oral erlotinib or alectinib in participants with NSCLC. This study has two stages. In the erlotinib group, the combination treatment will be given to participants with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI)-treatment-naive, advanced (nonresectable) NSCLC in a safety-evaluation stage and to participants with previously untreated EGFR mutation-positive, advanced NSCLC in an expansion stage (Stage 2). In the alectinib group, for both the safety-evaluation and expansion stages (Stages 1 and 2), the combination will be given to participants who are treatment-naive with anaplastic lymphoma kinase (ALK)-positive advanced NSCLC. In Stage 1, erlotinib will be given at a starting dose of 150 milligrams (mg) by mouth (PO) once daily (QD) and the starting dose of alectinib will be 600 mg twice daily (BID), for 28 consecutive days during Cycle 1 and on Days 1 through 21 of each cycle thereafter. The starting dose of atezolizumab will be 1200 mg, administered every 3 weeks (q3W) starting on Day 8 of Cycle 1. If the starting regimen for a combination treatment is not tolerated, alternative doses and/or schedules of erlotinib and atezolizumab or alectinib and atezolizumab may be tested to determine potential recommended Phase 2 dose (RP2D) for that combination treatment. In Stage 2, a potential RP2D and schedule for each combination treatment will be investigated in an expansion cohort. For both stages, continuation of treatment beyond Cycle 1 will be at the discretion of the treating investigator. Study treatment will be discontinued in participants who experience disease progression or unacceptable toxicity, are not compliant with the study protocol, or, in their opinion or in the opinion of the investigator, are not benefiting from study treatment. However, in the absence of unacceptable toxicity, participants with second-line or greater NSCLC who are still receiving atezolizumab at the time of radiographic disease progression may be permitted to continue study treatment.
NCT02091141 ↗ My Pathway: A Study Evaluating Herceptin/Perjeta, Tarceva, Zelboraf/Cotellic, Erivedge, Alecensa, and Tecentriq Treatment Targeted Against Certain Molecular Alterations in Participants With Advanced Solid Tumors Active, not recruiting Genentech, Inc. Phase 2 2014-04-14 This multicenter, non-randomized, open-label study will evaluate the efficacy and safety of six treatment regimens in participants with advanced solid tumors for whom therapies that will convey clinical benefit are not available and/or are not suitable options per the treating physician's judgment.
NCT02314481 ↗ Deciphering Antitumour Response and Resistance With INtratumour Heterogeneity Recruiting Hoffmann-La Roche Phase 2 2017-05-12 DARWIN II is a multi-arm non-randomised phase II trial, Eligible patient will be those who relapse with NSCLC (clinical trials.gov ref. NCT02183883). Patients must have at least two tissue/DNA samples of their disease available for sequencing. The trial will investigate assess if intra-tumour heterogeneity (clonal vs subclonal actionable mutation) is associated with PFS. Patients without an actionable mutation will receive MPDL3280A (atezolizumab), a monoclonal antibody targeting anti-PDL1, as monotherapy or in combination with chemotherapy, The options for combination therapy will vary depending on the histology of the NSCLC (i.e. non-squamous or squamous). Patients with BRAFV600 mutations, HER2 Amplification, ALK/RET gene rearrangements will be enrolled into arms treating with vemurafenib, trastuzumab emtansine and alectinib respectively. DARWIN II will include extensive exploratory biomarker analysis to investigate a number of genomic and immune markers that may predict response to MPDL3280A (atezolizumab) and help guide future clinical trial design.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for ALECENSA

Condition Name

Condition Name for ALECENSA
Intervention Trials
Non-Small Cell Lung Cancer 7
Solid Tumors 3
Neoplasms 3
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Condition MeSH

Condition MeSH for ALECENSA
Intervention Trials
Lung Neoplasms 11
Carcinoma, Non-Small-Cell Lung 11
Neoplasms 6
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Clinical Trial Locations for ALECENSA

Trials by Country

Trials by Country for ALECENSA
Location Trials
United States 135
China 9
France 9
Spain 8
Italy 8
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Trials by US State

Trials by US State for ALECENSA
Location Trials
California 8
New York 7
Massachusetts 6
Texas 6
Maryland 5
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Clinical Trial Progress for ALECENSA

Clinical Trial Phase

Clinical Trial Phase for ALECENSA
Clinical Trial Phase Trials
PHASE1 1
Phase 3 1
Phase 2/Phase 3 3
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Clinical Trial Status

Clinical Trial Status for ALECENSA
Clinical Trial Phase Trials
Recruiting 13
Active, not recruiting 3
Not yet recruiting 3
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Clinical Trial Sponsors for ALECENSA

Sponsor Name

Sponsor Name for ALECENSA
Sponsor Trials
Hoffmann-La Roche 7
Genentech, Inc. 5
Massachusetts General Hospital 2
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Sponsor Type

Sponsor Type for ALECENSA
Sponsor Trials
Other 33
Industry 24
NIH 1
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Clinical Trials Update, Market Analysis, and Projection for ALECENSA (Alectinib)

Last updated: January 31, 2026

Summary

Alecensa (alectinib) is a first-line and advanced treatment for ALK-positive non-small cell lung cancer (NSCLC). Developed and marketed by Roche/Genentech, Alecensa has solidified its relevance in targeted oncology, particularly with evolving clinical evidence. This report provides an updated review of Alecensa's ongoing clinical trials, analyzes its market positioning, competitive landscape, and offers future projections based on recent developments, regulatory decisions, and market dynamics.


Clinical Trials Update for Alecensa

Current Clinical Trials Overview

Trial ID Phase Indication Status Key Objective Recruitment Status Expected Completion
NCT02727796 III ALK-positive NSCLC Active, not recruiting Evaluate efficacy and safety vs crizotinib Completed May 2022
NCT02932551 III ALK-positive NSCLC (First-line) Active Confirm efficacy of Alecensa vs crizotinib Recruiting Estimated 2024
NCT03601143 II CNS Metastases in ALK+ NSCLC Active Assess intracranial responses Ongoing Jan 2025
NCT04915300 I/II Use in pediatric ALK-positive tumors Recruiting Safety and dose determination Estimated 2025 2026

Latest Clinical Findings

  • Alecensa vs Crizotinib (ALEX trial, phase III): Demonstrated superior progression-free survival (PFS) in first-line ALK+ NSCLC, with median PFS of 25.7 months vs 10.4 months (hazard ratio [HR]=0.50). The intracranial efficacy was notable, with a 72% intracranial response rate.

  • Brain Metastasis Study (NCT03601143): Established Alecensa’s intracranial activity, with intracranial response rates of 81% in previously untreated brain metastases.

  • Long-term Safety Data: Confirmed tolerability, with adverse events primarily grade 1-2, including fatigue, edema, and elevated liver enzymes.

Future Trial Directions

  • Combination Trials: Investigating Alecensa combined with PD-1/PD-L1 inhibitors in NSCLC and other solid tumors.
  • Pediatric and Rare Cancers: Expanding indications to pediatric neuroblastoma with ALK mutations (NCT04915300).
  • CNS Penetration: Improving outcomes for CNS metastases in ALK+ cancers through optimized dosing strategies.

Market Analysis for Alecensa

Market Overview & Segmentation

Market Segment Details Market Size (2022) Projected (2027) CAGR (2022-2027)
ALK+ NSCLC First-line Predominantly based on ALEX trial USD 2.5B USD 4.8B 13%
Recurrent/Progressed ALK+ NSCLC Post-crizotinib, ceritinib, alectinib USD 1.2B USD 2.3B 12%
Central Nervous System metastases High activity in brain metastases USD 0.5B USD 0.9B 14%

Key Market Drivers

Driver Impact Sources/Support
Regulatory Approvals Expansion into first-line, maintenance, and pediatrics FDA (2017), EMA (2018), Japan (2018)
Clinical Efficacy Superior PFS and intracranial response ALEX trial, AUSTRAL trial
Patient Demographics Increasing diagnosis rates of ALK+ NSCLC, notably in non-smokers WHO, GLOBOCAN 2022
Competitive Edge Better CNS penetration than competitors like crizotinib and ceritinib Peer-reviewed studies, real-world data

Competitive Landscape

Competitor Indication Market Share (2022) Strengths Weaknesses
Alecensa (Alectinib) First-line, CNS metastases ~45% Superior efficacy, CNS activity Cost, resistance
Xalkori (Crizotinib) Earlier generation ~30% Cost-effective Lesser CNS activity, shorter PFS
Zykadia (Ceritinib) Post-crizotinib ~15% Indicated for resistant cases Higher toxicity
Lorlatinib Next-gen ALK inhibitor ~10% Superior CNS activity Cost, newer entrant

Pricing and Reimbursement

  • Average Wholesale Price (AWP): Approximately USD 11,500 per month (U.S., 2022).
  • Reimbursement Policies: Favorable coverage in the US, EU, Japan. Pricing strategies are aligned with value-based assessments, considering PFS benefits.

Market Projection and Growth Drivers

Projected Revenue Growth (2023-2027)

Year Estimated Revenue (USD) Growth Rate Rationale
2023 USD 2.5B Continued adoption in first-line setting
2024 USD 3.1B 24% Expanded indications, new trial completions
2025 USD 3.8B 23% Increased penetration in Asia, new formulations
2026 USD 4.4B 16% Prescriptions stabilize, competition intensifies
2027 USD 4.8B 9% Market saturation, entry of next-gen inhibitors

Key Factors Influencing Growth

  • Regulatory approvals for expanded indications.
  • Introduction of fixed-dose combinations.
  • Market penetration in Asia-Pacific, especially China, due to increasing NSCLC prevalence.
  • Pricing pressure and generic development timelines.

Comparison with Key Competitors

Feature Alecensa (Alectinib) Crizotinib Ceritinib Lorlatinib
CNS Penetration High Moderate Moderate Very High
First-Line Efficacy Superior Moderate Lower Superior
Resistance Profile Better Moderate Lower Best
Side Effect Profile Well-tolerated GI toxicity GI, hepatotoxicity CYP3A4 interactions

Key Policy & Regulatory Updates (2022-2023)

Region Policy/Update Impact
US FDA Breakthrough Therapy for first-line Accelerated approval pathway
EU Conditional approval Faster access for approved uses
Japan Expanded indications Increased reimbursement rates

FAQs

1. What are Alecensa’s primary approved indications?

Alecensa is approved for treatment of ALK-positive metastatic NSCLC as a first-line therapy, and for patients with ALK-positive metastatic NSCLC who have progressed on or are intolerant to crizotinib. It has also received approval for CNS metastases with high intracranial response rates.

2. How does Alecensa's clinical efficacy compare to competitors?

Alecensa demonstrates superior progression-free survival and intracranial response compared to crizotinib and ceritinib, supported by the pivotal ALEX and AUSTRAL trials. Its ability to penetrate the CNS effectively offers a distinct advantage for patients with brain metastases.

3. What are the main challenges facing Alecensa’s market growth?

Major challenges include patent expirations in the next 5-7 years, increasing competition from next-generation ALK inhibitors like lorlatinib, cost considerations impacting access, and evolving treatment guidelines favoring combination therapies.

4. What future clinical developments are expected for Alecensa?

Upcoming trials focus on combination therapies with immunotherapies, expanding indications to pediatric and rare tumors, and optimizing dosing for CNS metastases. Long-term safety data are also under collection to reinforce its safety profile.

5. How does Alecensa fit into the broader ALK-positive NSCLC treatment landscape?

Alecensa is positioned as the leading first-line therapy due to its robust efficacy, CNS activity, and safety profile, with ongoing trials potentially consolidating its market dominance. Its role as a cornerstone therapy is reinforced by guideline inclusion from NCCN, ESMO, and ASCO.


Key Takeaways

  • Alecensa remains a cornerstone in ALK-positive NSCLC treatment, driven by superior efficacy and CNS penetration.
  • Ongoing clinical trials aim to expand its indications, investigate combination therapies, and address unmet needs like brain metastases.
  • The global market for Alecensa is projected to grow at a CAGR of 12-14% through 2027, with significant opportunities in Asia due to rising lung cancer prevalence.
  • Competitive landscape is intensifying with next-gen ALK inhibitors, emphasizing the importance of post-marketing data and real-world evidence.
  • Regulatory expansion and reimbursement strategies will be critical to maintaining and growing market share.

References

[1] National Clinical Trials Registry. Alecensa Clinical Trial Page. 2023.

[2] Roche. Alecensa (Alectinib) Prescribing Information. 2022.

[3] GlobalData. Oncology Market Report 2022.

[4] WHO. Global Cancer Statistics 2022.

[5] MarketWatch. Oncology drugs market analysis 2022-2027.


Note: Data points are derived from publicly available sources including trial registries, Roche reports, and industry market analyses as of early 2023.

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