Latest Cancer TreatmentsDr. Mohammadreza Dabiri
Dr. Mohammadreza Dabiriفارسی
Treatment regimen

Adjuvant alectinib after surgery for ALK-positive lung cancer (ALINA)

Two years of alectinib instead of adjuvant chemotherapy

Updated: 28 October 20261 min read2 references

Summary for doctors

  • Resected ALK-positive lung cancer, stage IB (4 cm or more) to IIIA [1].
  • Much longer disease-free survival than platinum chemotherapy [1].

Dose and schedule

Adjuvant alectinib

ALK-positive lung cancer after surgeryCycle length: Daily

ALK-positive lung cancer after surgery

DrugDoseRouteSchedule
Alectinib600 mg twice a dayOral, with foodDaily
Cycle length
Daily
Duration
2 years

As in ALINA [1]; dose source: [2].

Evidence: ALINA (2024)

Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.

Premedication and supportive care

  • With food; liver enzymes and CPK in the first months; heart rate (bradycardia).

Monitoring and dose adjustment

  • Liver enzymes every 2 weeks for the first 3 months; myalgia and CPK; ILD [2].

Main evidence

Show detailsHide

ALINA: 2-year disease-free survival 93.8% vs 63.0% with chemotherapy in stage II to IIIA [1].

Related cancer types

Lung cancer

Treatment regimens (physicians)

Trastuzumab deruxtecan (T-DXd, Enhertu): dose and monitoringCarboplatin, pemetrexed and pembrolizumab (KEYNOTE-189)Carboplatin, paclitaxel and pembrolizumab (KEYNOTE-407)Carboplatin-etoposide with atezolizumab or durvalumab in small cell lung cancerDurvalumab after chemoradiotherapy in stage 3 lung cancer (PACIFIC)Pembrolizumab alone in lung cancer with high PD-L1 (KEYNOTE-024)Osimertinib with pemetrexed and platinum (FLAURA2)Amivantamab with lazertinib (MARIPOSA)

Physician tools and lessons

Khorana Score (Cancer-Associated Thrombosis Risk)Should I Be Screened for Lung Cancer? (Pack-Year Calculator)10 cheap steps that save patients' livesManagement of brain metastasesMalignant pleural effusion: drainage, pleurodesis or an indwelling catheter

References

2 references
Show all references, 1 with a study cardClose the reference list

Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.

  1. 1
    Alectinib in Resected ALK-Positive Non-Small-Cell Lung CancerWu YL, Dziadziuszko R, Ahn JS, et al · N Engl J Med · 2024;390:1265-1276
    Study cardDOIPubMed Back to text: 1 2 3 4
  2. 2
    ALECENSA (ALECTINIB HYDROCHLORIDE) — Prescribing InformationGenentech, Inc · FDA label · 2026
    Source Back to text: 1 2

This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.

Printed from the website; the full and up-to-date version: https://drdabiri.com/en/regimens/alectinib-adjuvant-alina/

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