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Nuvalent Announces Initiation of ALKAZAR Phase 3 Randomized, Controlled Trial Evaluating Neladalkib for Patients with TKI-naïve ALK-positive NSCLC

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Nuvalent (NASDAQ: NUVL) has initiated ALKAZAR, a global Phase 3 randomized controlled trial evaluating neladalkib for treatment-naive patients with advanced ALK-positive non-small cell lung cancer (NSCLC). The study will compare neladalkib against ALECENSA® (alectinib), a current front-line standard treatment.

The trial will enroll approximately 450 TKI-naïve patients, randomized 1:1 to receive either neladalkib or alectinib monotherapy. The primary endpoint is progression-free survival (PFS), with multiple secondary endpoints including overall survival and intracranial response measures.

Neladalkib is also being evaluated in the ALKOVE-1 Phase 1/2 trial, where Phase 1 data showed durable clinical responses in heavily pre-treated patients, including those with brain metastases and resistance mutations. Topline pivotal data from ALKOVE-1's Phase 2 portion is expected by year-end 2025.

Nuvalent (NASDAQ: NUVL) ha avviato ALKAZAR, uno studio controllato randomizzato di Fase 3 a livello globale che valuta neladalkib per pazienti con carcinoma polmonare non a piccole cellule (NSCLC) ALK-positivo avanzato, mai trattati in precedenza. Lo studio confronterà neladalkib con ALECENSA® (alectinib), attuale trattamento standard di prima linea.

La sperimentazione arruolerà circa 450 pazienti naïve a TKI, randomizzati 1:1 per ricevere neladalkib o monoterapia con alectinib. L'endpoint primario è la sopravvivenza libera da progressione (PFS), con diversi endpoint secondari tra cui la sopravvivenza globale e la risposta intracranica.

Neladalkib è inoltre in valutazione nello studio ALKOVE-1 di Fase 1/2, dove i dati di Fase 1 hanno evidenziato risposte cliniche durature in pazienti fortemente pretrattati, inclusi quelli con metastasi cerebrali e mutazioni di resistenza. I dati principali della porzione di Fase 2 di ALKOVE-1 sono attesi entro la fine del 2025.

Nuvalent (NASDAQ: NUVL) ha iniciado ALKAZAR, un ensayo global aleatorizado controlado de Fase 3 que evalúa neladalkib en pacientes con cáncer de pulmón no microcítico (CPNM) avanzado ALK-positivo sin tratamiento previo. El estudio comparará neladalkib con ALECENSA® (alectinib), el tratamiento estándar actual de primera línea.

El ensayo incluirá aproximadamente 450 pacientes sin tratamiento previo con TKI, asignados aleatoriamente 1:1 para recibir monoterapia con neladalkib o alectinib. El criterio principal de valoración es la supervivencia libre de progresión (SLP), con múltiples criterios secundarios que incluyen la supervivencia global y la respuesta intracraneal.

Neladalkib también se está evaluando en el ensayo ALKOVE-1 de Fase 1/2, donde los datos de Fase 1 mostraron respuestas clínicas duraderas en pacientes muy pretratados, incluidos aquellos con metástasis cerebrales y mutaciones de resistencia. Se esperan datos clave de la fase 2 de ALKOVE-1 para finales de 2025.

Nuvalent (NASDAQ: NUVL)� 치료 경험� 없는 진행� ALK 양성 비소세포폐암(NSCLC) 환자� 대상으� 넬라달키브를 평가하는 글로벌 3� 무작� 대� 시험� ALKAZAR� 시작했습니다. � 연구� 넬라달키브와 현재 1� 표준 치료제인 ALECENSA® (알렉티닙)� 비교합니�.

시험은 � 450명의 TKI 미경� 환자� 1:1 비율� 무작� 배정하여 넬라달키� 또는 알렉티닙 단독요법� 투여합니�. 주요 평가 변수는 무진� 생존기간(PFS)이며, 전체 생존율과 뇌내 반응 지� � 여러 2� 평가 변수도 포함됩니�.

넬라달키브는 또한 ALKOVE-1 1/2� 시험에서� 평가 중이�, 1� 데이터에서는 � 전이 � 내성 돌연변이를 가� 중증 다중 치료 환자에서 내구� 있는 임상 반응� 보였습니�. ALKOVE-1 2� 주요 데이터는 2025� 말까지 발표� 예정입니�.

Nuvalent (NASDAQ : NUVL) a lancé ALKAZAR, un essai contrôlé randomisé mondial de phase 3 évaluant le neladalkib chez des patients atteints d'un cancer du poumon non à petites cellules (NSCLC) ALK-positif avancé, n'ayant jamais reçu de traitement. L'étude comparera le neladalkib à ALECENSA® (alectinib), traitement standard actuel en première ligne.

L'essai recrutera environ 450 patients naïfs de TKI, randomisés 1:1 pour recevoir soit le neladalkib, soit une monothérapie par alectinib. Le critère principal d'évaluation est la survie sans progression (SSP), avec plusieurs critères secondaires incluant la survie globale et la réponse intracrânienne.

Le neladalkib est également évalué dans l'essai ALKOVE-1 de phase 1/2, où les données de phase 1 ont montré des réponses cliniques durables chez des patients lourdement prétraités, y compris ceux présentant des métastases cérébrales et des mutations de résistance. Les données principales de la phase 2 d'ALKOVE-1 sont attendues d'ici la fin 2025.

Nuvalent (NASDAQ: NUVL) hat ALKAZAR gestartet, eine globale randomisierte Phase-3-Studie, die Neladalkib bei unbehandelten Patienten mit fortgeschrittenem ALK-positivem nicht-kleinzelligem Lungenkarzinom (NSCLC) untersucht. Die Studie vergleicht Neladalkib mit ALECENSA® (Alectinib), der derzeitigen Standard-Erstlinienbehandlung.

Die Studie wird etwa 450 TKI-naive Patienten einschließen, die im Verhältnis 1:1 randomisiert werden, um entweder Neladalkib oder Alectinib als Monotherapie zu erhalten. Der primäre Endpunkt ist das progressionsfreie Überleben (PFS), mit mehreren sekundären Endpunkten, darunter das Gesamtüberleben und intrakranielle Ansprechmaße.

Neladalkib wird auch in der ALKOVE-1 Phase-1/2-Studie untersucht, wo die Phase-1-Daten anhaltende klinische Ansprechraten bei stark vorbehandelten Patienten zeigten, darunter solche mit Hirnmetastasen und Resistenzmutationen. Die wichtigsten Daten aus dem Phase-2-Teil von ALKOVE-1 werden bis Ende 2025 erwartet.

Positive
  • Neladalkib demonstrated durable clinical responses in heavily pre-treated patients during Phase 1
  • Drug shows efficacy in patients with brain metastases and resistance mutations
  • Generally safe and well-tolerated preliminary safety profile
  • Large Phase 3 trial with 450 patients indicates strong development progress
Negative
  • Phase 3 results not yet available - efficacy against current standard of care unproven
  • Competition from established treatments like ALECENSA already in the market

Insights

Nuvalent's Phase 3 ALKAZAR trial for neladalkib represents significant advancement in ALK+ NSCLC treatment with potential advantages over current therapies.

Nuvalent has dosed the first patient in their Phase 3 ALKAZAR trial evaluating neladalkib against the current standard-of-care alectinib (Alecensa) in treatment-naïve ALK-positive non-small cell lung cancer patients. This represents a critical advancement in their clinical development program.

The trial design demonstrates scientific rigor with approximately 450 patients being randomized 1:1 between neladalkib and alectinib. The primary endpoint of progression-free survival (PFS) based on blinded independent review is the gold standard for oncology trials, while secondary endpoints comprehensively assess both systemic and intracranial efficacy.

What makes neladalkib particularly promising is its dual-targeting approach. The compound is specifically designed to address two major challenges in ALK-positive NSCLC: brain metastases (occurring in 30-50% of patients) and treatment-emergent resistance mutations. Previous Phase 1 data indicated efficacy in heavily pre-treated patients, including those with brain metastases and resistance mutations who had exhausted available therapies.

This trial complements their ongoing Phase 2 ALKOVE-1 study in TKI pre-treated patients, with topline data expected by year-end 2025. The parallel development in both treatment-naïve and pre-treated populations represents a comprehensive clinical strategy.

For context, while current ALK inhibitors have improved outcomes, they still face limitations in durability and CNS penetration. If neladalkib demonstrates superior efficacy, particularly in preventing or treating brain metastases while maintaining tolerability suitable for long-term administration, it could establish a new standard of care in this patient population with significant unmet needs.

CAMBRIDGE, Mass., July 21, 2025 /PRNewswire/ -- (Nasdaq: NUVL), a clinical-stage biopharmaceutical company focused on creating precisely targeted therapies for clinically proven kinase targets in cancer, today announced that the first patient has been dosed in ALKAZAR, the company's global Phase 3 randomized, controlled trial evaluating neladalkib for TKI-naïve patients with advanced ALK-positive non-small cell lung cancer (NSCLC), versus ALECENSA® (alectinib), a front-line standard of care.

"Neladalkib is rationally designed with the goal of addressing the combined medical needs of treating key drivers of disease progression such as brain metastases and treatment-emergent resistance mutations, while also offering a generally safe and well-tolerated safety profile supportive of long-term treatment," said Darlene Noci, A.L.M., Chief Development Officer at Nuvalent. "We have been encouraged by neladalkib's clinical profile to date, which we believe not only supports its potential to address clear medical needs for TKI pre-treated patients with advanced ALK-positive NSCLC, but also to translate to deep, durable responses for patients in the front-line setting. The initiation of the registration-directed ALKAZAR study enables us to explore this potential by comparing neladalkib to a front-line standard of care in a randomized, controlled clinical trial setting, and advances us towards our ultimate goal of bringing neladalkib to all patients with advanced ALK-positive NSCLC."

The ALKAZAR trial is designed to enroll approximately 450 TKI-naïve patients with advanced ALK-positive NSCLC. Patients will be randomized 1:1 to receive neladalkib monotherapy or alectinib monotherapy, reflecting input from collaborating physician-scientists and alignment with global regulatory agencies. The primary endpoint is progression free survival (PFS) based on Blinded Independent Central Review (BICR). Secondary endpoints include overall survival, PFS based on investigator's assessment, time to intracranial response, and BICR assessment of intracranial objective response rate (IC-ORR), intracranial duration of response (IC-DOR), objective response rate (ORR), duration of response (DOR), time to intracranial progression, and safety. Additional details can be found on ().

Neladalkib is also being evaluated in the Phase 2 portion of the ALKOVE-1 Phase 1/2 trial for TKI pre-treated patients with advanced ALK-positive NSCLC. demonstrated that treatment with neladalkib resulted in durable clinical responses in heavily pre-treated patients. This included subgroups of patients who had likely exhausted all available therapies, including lorlatinib, had a history of brain metastases, and/or had single or compound ALK resistance mutations. Additionally, neladalkib demonstrated a generally safe and well-tolerated preliminary safety profile consistent with its ALK-selective, TRK-sparing design. The company expects to report topline pivotal data for TKI pre-treated patients with advanced ALK-positive NSCLC from the Phase 2 portion of ALKOVE-1 by year-end 2025.

"The currently available therapies represent important scientific advancements that provide hope for patients with ALK-positive NSCLC. However, these therapies have limitations that can lead to challenging treatment decisions for newly diagnosed patients and their health care providers," said Kirk Smith, President of the Board of ALK Positive Inc. "We encourage continued innovation and the investigation of new treatment opportunities for all patients with ALK-positive NSCLC and look forward to following the progress of the ALKAZAR study."

About Neladalkib
Neladalkib is a novel brain-penetrant ALK-selective inhibitor created with the aim to overcome limitations observed with currently available ALK inhibitors. Neladalkib is designed to remain active in tumors that have developed resistance to first-, second-, and third-generation ALK inhibitors, including tumors with single or compound treatment-emergent ALK mutations such as G1202R. In addition, neladalkib is designed for central nervous system (CNS) penetrance to improve treatment options for patients with brain metastases, and to avoid inhibition of the structurally related tropomyosin receptor kinase (TRK) family. Together, these characteristics have the potential to avoid TRK-related CNS adverse events seen with dual TRK/ALK inhibitors and to drive deep, durable responses for patients across all lines of therapy. Neladalkib has received breakthrough therapy designation for the treatment of patients with locally advanced or metastatic ALK-positive non-small cell lung cancer (NSCLC) who have been previously treated with 2 or more ALK tyrosine kinase inhibitors and orphan drug designation for ALK-positive NSCLC.

About Nuvalent
Nuvalent, Inc. (Nasdaq: NUVL) is a clinical-stage biopharmaceutical company focused on creating precisely targeted therapies for patients with cancer, designed to overcome the limitations of existing therapies for clinically proven kinase targets. Leveraging deep expertise in chemistry and structure-based drug design, we develop innovative small molecules that have the potential to overcome resistance, minimize adverse events, address brain metastases, and drive more durable responses. Nuvalent is advancing a robust pipeline with investigational candidates for ROS1-positive, ALK-positive, and HER2-altered non-small cell lung cancer, and multiple discovery-stage research programs.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, as amended, including, without limitation, implied and express statements regarding Nuvalent's strategy, business plans, and focus; the expected timing of data announcements; the clinical development program for neladalkib; the potential clinical effects of neladalkib; the design and enrollment of Nuvalent's clinical trials, including for the ALKAZAR trial its intended pivotal registration-directed design; the potential of Nuvalent's pipeline programs, including neladalkib; the implications of data readouts; Nuvalent's research and development programs for the treatment of cancer; and risks and uncertainties associated with drug development. The words "may," "might," "will," "could," "would," "should," "expect," "plan," "anticipate," "aim," "goal," "intend," "believe," "expect," "estimate," "seek," "predict," "future," "project," "potential," "continue," "target" or the negative of these terms and similar words or expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. Drug development and commercialization involve a high degree of risk, and only a small number of research and development programs result in commercialization of a product. You should not place undue reliance on these statements or the scientific data presented.

Any forward-looking statements in this press release are based on management's current expectations and beliefs and are subject to a number of risks, uncertainties, and important factors that may cause actual events or results to differ materially from those expressed or implied by any forward-looking statements contained in this press release, including, without limitation: risks that Nuvalent may not fully enroll its clinical trials or that enrollment will take longer than expected; unexpected concerns that may arise from additional data, analysis, or results obtained during preclinical studies and clinical trials; the risk that preliminary results of clinical trials may not be predictive of future results from the same or other trials; the risk that results of earlier clinical trials may not be predictive of the results of later-stage clinical trials; the risk that data from our clinical trials may not be sufficient to support registration and that Nuvalent may be required to conduct one or more additional studies or trials prior to seeking registration of neladalkib; the occurrence of adverse safety events; risks that the FDA may not approve our potential products on the timelines we expect, or at all; risks of unexpected costs, delays, or other unexpected hurdles; risks that Nuvalent may not be able to nominate drug candidates from its discovery programs; the direct or indirect impact of public health emergencies or global geopolitical circumstances on the timing and anticipated timing and results of Nuvalent's clinical trials, strategy, and future operations, including the ALKAZAR trial; the timing and outcome of Nuvalent's planned interactions with regulatory authorities; and risks related to obtaining, maintaining, and protecting Nuvalent's intellectual property. These and other risks and uncertainties are described in greater detail in the section entitled "Risk Factors" in Nuvalent's Quarterly Report on Form 10-Q for the quarter ended March 31, 2025, as well as any prior and subsequent filings with the Securities and Exchange Commission. In addition, any forward-looking statements represent Nuvalent's views only as of today and should not be relied upon as representing its views as of any subsequent date. Nuvalent explicitly disclaims any obligation to update any forward-looking statements.

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FAQ

What is the primary endpoint of Nuvalent's (NUVL) ALKAZAR Phase 3 trial?

The primary endpoint is progression-free survival (PFS) based on Blinded Independent Central Review (BICR).

How many patients will be enrolled in Nuvalent's ALKAZAR Phase 3 trial?

The trial will enroll approximately 450 TKI-naïve patients with advanced ALK-positive NSCLC, randomized 1:1 to receive neladalkib or alectinib monotherapy.

When will Nuvalent (NUVL) report topline data from the ALKOVE-1 Phase 2 trial?

Nuvalent expects to report topline pivotal data from the Phase 2 portion of ALKOVE-1 by year-end 2025.

What type of patients is neladalkib designed to treat?

Neladalkib is designed to treat patients with ALK-positive non-small cell lung cancer (NSCLC), particularly addressing brain metastases and treatment-emergent resistance mutations.

What were the key findings from neladalkib's Phase 1 trial?

Phase 1 data showed durable clinical responses in heavily pre-treated patients, including those with brain metastases and resistance mutations, with a generally safe and well-tolerated safety profile.
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