Alectinib
Alectinib is a well-tolerated ALK pill, standard first line for years and, since 2024, the first targeted therapy given after surgery for ALK-positive lung cancer.
ALEX (2017): PFS 34.8 vs 10.9 months versus crizotinib with strong CNS control. ALINA (2024): adjuvant alectinib cut recurrence by 76% versus chemotherapy. Being challenged first line by lorlatinib (CROWN) and, in the ALKAZAR trial, by neladalkib.
- Medicare
- Part D (self-administered)
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026).
- Commercial insurance
- covered with prior authorisation
Covered for FDA-labelled and NCCN-listed uses, but almost always behind prior authorisation confirming diagnosis, biomarker and line of therapy; dispensed through a specialty pharmacy. ALK rearrangement by an approved test.
- Assistance programmes
- Genentech Access Solutions
- Genentech Patient Foundation — Free medicine for eligible patients regardless of insurance type.
- PAN Foundation — Disease-specific co-pay and premium funds; open and closed funds change monthly.
- HealthWell Foundation
- CancerCare Co-Payment Assistance Foundation
- Patient Advocate Foundation Co-Pay Relief
Part D out-of-pocket capped at $2,000 (2025) / $2,100 (2026). Medicare patients cannot use manufacturer co-pay cards; charity funds (PAN, HealthWell, CancerCare) and the Extra Help subsidy are the routes.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
- Appraised for
- Untreated ALK-positive advanced NSCLC
- Notes
- Adjuvant ALK-positive NSCLC (ALINA) appraised 2024-25; check NICE.
- NHS England
- Routinely funded for the appraised indication (or via managed access)
Sources: NICE TA536 · SMC advice: alectinib. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2015 | ALK+ NSCLC after crizotinib |
| US | 2017 | First-line ALK+ NSCLC |
| US | 2024 | Adjuvant ALK+ NSCLC after resection (stage IB ≥4 cm to IIIA) |
Trials
topRecruiting now (live from ClinicalTrials.gov)
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Landmark trials in OnCo
Latest papers
topQuery for this drug: (TITLE:"Alectinib" OR ABSTRACT:"Alectinib" OR TITLE:"Alecensa" OR ABSTRACT:"Alecensa") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Alectinib, not a curated reading list.
Pages like this
not linked directly; found by shared links- TrialALKOVE-1
Shares Neladalkib, ALK, Non-small-cell lung cancer.
- ProductEnsartinib
Shares ALK, Small-molecule kinase inhibitors, Non-small-cell lung cancer.
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- ProductCeritinib
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- ProductBrigatinib
Shares ALK, Small-molecule kinase inhibitors, Non-small-cell lung cancer.
- CompanyNuvalent
Shares Neladalkib, Non-small-cell lung cancer.
- ProductLorlatinib
Shares Neladalkib, Prevention trials aimed only at brain metastasis, The blood–brain barrier & brain metastasis, ALK.
- TrialADAURA
Shares ALINA, Prevention trials aimed only at brain metastasis, Non-small-cell lung cancer.