A crowded, but still varied, space: brigatinib in anaplastic lymphoma kinase-rearranged non-small cell lung cancer

Considering that, as recently as 10 years ago, physicians caring for patients with advanced lung cancer had only a handful of conventional cytotoxic agents from which to choose, the field’s recent development and competition seem truly remarkable. A prime example of this shifting and crowded landscape is immunotherapy. Since 2015, three different checkpoint inhibitors targeting programmed death 1 (PD-1) or PD-1 ligand (PD-L1) have received U.S. FDA approval, with several others currently in clinical trials. While these drugs may differ by specific target (PD-1 versus PD-L1), antibody species (humanized versus fully human), and IgG subclass (IgG1 versus IgG4), it remains unclear whether there are clinically meaningful differences in efficacy or toxicity between these agents.