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Alectinib and ceritinib are both second-generation anaplastic lymphoma kinase (ALK) inhibitors used for the treatment of ALK-positive metastatic non-small cell lung cancer (NSCLC). Both drugs were developed to overcome resistance to crizotinib, the first-generation ALK inhibitor. Alectinib is approximately 20 times more potent than crizotinib in inhibiting ALK, while ceritinib has shown activity against common crizotinib-resistant mutations including L1196M and G1269A. Both medications have demonstrated efficacy in patients with brain metastases due to their superior brain penetration compared to crizotinib. These drugs are not typically administered together but rather used as alternative treatment options.
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