{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:47:44Z","timestamp":1792054064750,"version":"4.4.0"},"reference-count":26,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study compared the efficacy of first\u2010line alectinib versus ceritinib and evaluated the role of upfront brain radiotherapy (RT) in patients with ALK\u2010positive non\u2010small cell lung cancer (NSCLC) and brain metastases (BM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 108 patients with ALK\u2010positive NSCLC and baseline BM treated with first\u2010line alectinib (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200942) or ceritinib (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200966) at two Vietnamese centers between 2019 and 2025. Intracranial and systemic responses were assessed by RANO\u2010BM and RECIST v1.1 criteria, respectively. Survival outcomes were analyzed using the Kaplan\u2013Meier method and multivariable Cox regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      First\u2010line alectinib demonstrated superior intracranial disease control compared with ceritinib (iDCR 97.6% vs. 83.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026; median iPFS 40.4 vs. 17.2\u2009months, univariable HR 0.46, 95% CI 0.26\u20130.82,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). Systemic PFS was also significantly longer with alectinib (35.9 vs. 11.5\u2009months, univariable HR 0.38, 95% CI 0.22\u20130.65,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Exploratory subgroup analyses suggested differential effects of upfront brain RT by TKI, but interaction tests were non\u2010significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.642 for iPFS,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.837 for systemic PFS). In multivariable analysis, alectinib remained an independent predictor of better iPFS (HR 0.38, 95% CI 0.20\u20130.70,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and systemic PFS (HR 0.34, 95% CI 0.20\u20130.59,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Grade \u2265\u20093 adverse events occurred in 19.0% of patients with alectinib versus 34.8% with ceritinib (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.068).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this real\u2010world Vietnamese cohort, first\u2010line alectinib showed superior intracranial and systemic efficacy over ceritinib. In resource\u2010limited settings, ceritinib combined with upfront brain RT is a reasonable clinical alternative. The differential benefit of brain RT between the two TKIs remains hypothesis\u2010generating.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1759-7714.70325","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T14:30:42Z","timestamp":1781793042000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["First\u2010Line Alectinib Versus Ceritinib With or Without Brain Radiotherapy in\n                    <scp>ALK<\/scp>\n                    \u2010Positive Non\u2010Small Cell Lung Cancer with Brain Metastases: A Real\u2010World Multicenter Study from Vietnam"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6759-9683","authenticated-orcid":false,"given":"Hoang Gia","family":"Nguyen","sequence":"first","affiliation":[{"name":"Lung and Breast Medical Oncology Department Hanoi Oncology Hospital  Hanoi Vietnam"},{"name":"Department of Oncology Hanoi Medical University  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan Hau","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Oncology Hanoi Medical University  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0249-3167","authenticated-orcid":false,"given":"Phuong","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Vietnam National Cancer Hospital \u2013 K Hospital  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0665-2227","authenticated-orcid":false,"given":"Thu Huong","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Lung and Breast Medical Oncology Department Hanoi Oncology Hospital  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4269-3605","authenticated-orcid":false,"given":"Quang Bui","family":"Vinh","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Hanoi Oncology Hospital  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.22.6993"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704795"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1810171"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2027187"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2021.3523"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2025.108436"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2017.10.003"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2204.0023"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2022.12.009"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2025.108858"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13153682"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.863715"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.07.2280"},{"key":"e_1_2_10_15_1","first-page":"219","volume-title":"Handbook of Clinical Neurology","author":"Dhermain F.","year":"2016"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30123-X"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30565-2"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr-2025-983"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2023.461"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2024.14357"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.4103\/jcrt.jcrt_1453_21"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyy016"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2017.07.005"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.69.7144"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2021.08.009"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.02668"},{"issue":"16","key":"e_1_2_10_27_1","first-page":"TPS2090\u2010TPS","article-title":"Delayed or Upfront Brain Radiotherapy in Treatment\u2010Na\u00efve Lung Cancer Patients With Asymptomatic or Minimally Symptomatic Brain Metastases and ALK Rearrangements (DURABLE)","volume":"43","author":"Palmer J. 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