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RO5424802

Phase 3FDA approved 2015

Undisclosed | Small molecule | Other |Roche Holding AG|Trials Updated: Oct 14, 2026

RO5424802 development status

FDA approval Dec 11, 2015 as Alecensa
Approval holderHoffmann-la Roche
ApplicationNDA208434
Highest phase Phase 3 (NCT03456076)
Phase scored for RHHBYPhase 1
Registered trials 43 across 12 sponsors since Feb 2013

Label indication ALECENSA is a kinase inhibitor indicated for: adjuvant treatment in adult patients following tumor resection of anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) (tumors ≥ 4 cm or node positive) as detected by an FDA-approved test. ( 1.1 ) treatment of adult patients with ALK-positive metastatic NSCLC as detected by an FDA-approved test. FDA label

RO5424802 target and mechanism

Molecular targetALK
Target classKinase
ModalitySmall molecule

Also known as Alectnib, Alectinib, Alecensa®, RG7853, CH5424802

Success Probability

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Market & Valuation

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Trial Design

RandomizedCONTROLLED
Total Trials20
Total Enrollment3,218

FDA Designations

No designations recorded

RO5424802 clinical trials

RO5424802 · 20 trials · 20 indications

Phase 3 7Phase 2 5Phase 1 8
NCT06624059A Study to See How Well and How Safely Different Treatments Work in a Group of Participants With Non-Small Cell Lung Cancer (NSCLC)Non-Small Cell Lung Cancer
COMPLETED11 Analytics
NCT05170204A Study Evaluating the Efficacy and Safety of Multiple Therapies in Cohorts of Participants With Locally Advanced, Unresectable, Stage III Non-Small Cell Lung Cancer (NSCLC)Non-Small Cell Lung Cancer
ACTIVE NOT_RECRUITING68 Analytics
NCT03456076A Study Comparing Adjuvant Alectinib Versus Adjuvant Platinum-Based Chemotherapy in Patients With ALK Positive Non-Small Cell Lung CancerCarcinoma, Non-Small-Cell Lung
ACTIVE NOT_RECRUITING257 Analytics
NCT03194893A Rollover Study of Alectinib in Patients With Anaplastic Lymphoma Kinase (ALK)-Positive or Rearranged During Transfection (RET)-Positive CancerNeoplasms
COMPLETED50 Analytics
NCT02838420A Study to Evaluate and Compare the Efficacy and Safety of Alectinib Versus Crizotinib and to Evaluate the Pharmacokinetics of Alectinib in Asian Participants With Treatment-Naive Anaplastic Lymphoma Kinase (ALK)-Positive Advanced Non-Small Cell Lung Cancer (NSCLC)Anaplastic Lymphoma Kinase-positive Non-small Cell Lung Cancer
COMPLETED187 Analytics
NCT02604342Alectinib Versus Pemetrexed or Docetaxel in Anaplastic Lymphoma Kinase (ALK)-Positive Advanced Non-Small Cell Lung Cancer (NSCLC) Participants Previously Treated With Platinum-Based Chemotherapy and CrizotinibNon-small Cell Lung Cancer
COMPLETED119 Analytics
NCT02075840A Study Comparing Alectinib With Crizotinib in Treatment-Naive Anaplastic Lymphoma Kinase-Positive Advanced Non-Small Cell Lung Cancer ParticipantsNon-Small Cell Lung Cancer
COMPLETED303 Analytics
PHASE3COMPLETED
A Study to See How Well and How Safely Different Treatments Work in a Group of Participants With Non-Small Cell Lung Cancer (NSCLC)
Non-Small Cell Lung CancerUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
A Study Evaluating the Efficacy and Safety of Multiple Therapies in Cohorts of Participants With Locally Advanced, Unresectable, Stage III Non-Small Cell Lung Cancer (NSCLC)
Non-Small Cell Lung CancerUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
A Study Comparing Adjuvant Alectinib Versus Adjuvant Platinum-Based Chemotherapy in Patients With ALK Positive Non-Small Cell Lung Cancer
Carcinoma, Non-Small-Cell LungUnlock trial analytics
PHASE3COMPLETED
A Rollover Study of Alectinib in Patients With Anaplastic Lymphoma Kinase (ALK)-Positive or Rearranged During Transfection (RET)-Positive Cancer
NeoplasmsUnlock trial analytics
PHASE3COMPLETED
A Study to Evaluate and Compare the Efficacy and Safety of Alectinib Versus Crizotinib and to Evaluate the Pharmacokinetics of Alectinib in Asian Participants With Treatment-Naive Anaplastic Lymphoma Kinase (ALK)-Positive Advanced Non-Small Cell Lung Cancer (NSCLC)
Anaplastic Lymphoma Kinase-positive Non-small Cell Lung CancerUnlock trial analytics
PHASE3COMPLETED
Alectinib Versus Pemetrexed or Docetaxel in Anaplastic Lymphoma Kinase (ALK)-Positive Advanced Non-Small Cell Lung Cancer (NSCLC) Participants Previously Treated With Platinum-Based Chemotherapy and Crizotinib
Non-small Cell Lung CancerUnlock trial analytics
PHASE3COMPLETED
A Study Comparing Alectinib With Crizotinib in Treatment-Naive Anaplastic Lymphoma Kinase-Positive Advanced Non-Small Cell Lung Cancer Participants
Non-Small Cell Lung CancerUnlock trial analytics

Study Endpoints

Primary Endpoints

Incidence, Type, and Severity of Adverse Events (AEs) With Onset up to 28 Days After the Last Dose of Chemotherapy
Up to 28 days after the last dose of chemotherapy treatment (up to 4 cycles, cycle length = 3 weeks)
Progression-free Survival (PFS), as Determined by Blinded Independent Central Review (BICR) per Response Evaluation Criterial in Solid Tumors Version 1.1 (RECIST V1.1)
From randomization to the first documented disease progression or death from any cause, whichever occurs first (up to 3 years)
Disease-free Survival (DFS), as Assessed by the Investigator
Approximately 58 months

DFS, defined as the time from randomization to the first documented recurrence of disease or new primary NSCLC as determined by the investigator through use of an integrated assessment of radiographic data, biopsy sample results (if clinically feasible), and clinical status or death from any cause, whichever occurs first

Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs) and Adverse Events of Special Interest (AESI)
From study initiation until 4 weeks after the last dose (up to approximately 8.19 years)

An AE is any untoward medical occurrence in a participant administered a study drug, regardless of causal relationship. A SAE is any untoward medical occurrence that results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, or is a medically important event. AESI included drug induced liver injury that include an elevated alanine aminotransferase (ALT) or aspartate aminotransferase (AST) in combination with either an elevated bilirubin or clinical jaundice and suspected transmission of infectious agent via study drug.

Progression-Free Survival (PFS) as Determined by Investigator Using Response Evaluation Criteria in Solid Tumor (RECIST) v1.1
From the date of randomization to the date of the first documented disease progression or death, whichever occurred first (up to overall period of approximately 40 months)

PFS was defined as the time (in months) from randomization to the first documentation of disease progression, as determined by the investigators, or to death from any cause, whichever occurred first.

Progression-Free Survival (PFS) Using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 as Assessed by Investigator
Randomization to first documented disease progression, death from any cause, or study end (up to 33 months)

PFS was defined as the time from randomization to the first documented disease progression, as determined using RECIST v1.1, or death from any cause, whichever occurred first. As per RECIST v1.1, disease progression is a 20% increase in the sum of the diameters of target lesions, an increase in size of measurable lesions by at least 5 millimeter (mm) and the appearance of new lesions.

Progression-Free Survival (PFS) by Investigator Assessment
Randomization to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to 33 months)

PFS was assessed as time to disease progression or death whichever occurred first by investigator assessment using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 (v1.1) Criteria. As per RECIST v1.1, disease progression is a 20% increase in the sum of the diameters of target lesions, an increase in size of measurable lesions by at least 5 millimeter (mm) and the appearance of new lesions.

Percentage of Participants With PFS Event by Investigator Assessment
Randomization to first documented disease progression or death, whichever occurs first (assessed every 8 weeks up to 33 months)

PFS was assessed percentage of participants with disease progression or death whichever occurred first by investigator assessment using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 (v1.1) Criteria. As per RECIST v1.1, disease progression is a 20% increase in the sum of the diameters of target lesions, an increase in size of measurable lesions by at least 5 millimeter (mm) and the appearance of new lesions.

Objective Response (OR)
Disease assessments to be performed up to 24 weeks from the start of trial treatment.

An OR is defined as the confirmed occurrence of either a Complete Response (CR) or Partial Response (PR) according to Response Evaluation Criteria in Solid Tumours (RECIST) Version 1.1 criteria (or immune related \[ir\]-RECIST or standard imaging criteria for specific disease e.g. Response Evaluation in Neuro Oncology criteria \[RANO\]). In patients with leukaemia, OR will be defined as the occurrence of CR, CRi (CR incomplete neutrophil recovery) or CRp (CR with incomplete platelet recovery). The trial will report the proportion of patients with an OR and 95% credible interval.

Durable Clinical Benefit (DCB)
Disease assessments to be performed up to 24 weeks from the start of trial treatment.

DCB is defined as the absence of disease progression for at least 24 weeks from the start of trial treatment according to RECIST Version 1.1 criteria (or ir-RECIST or standard imaging criteria for specific disease e.g. RANO criteria) and, where relevant (e.g. for haematological malignancies), by standard bone marrow response assessment criteria. Alternative definitions of DCB based on different time points may be pre-specified for particular sub-cohorts if 24 weeks is not clinically relevant. The trial will report the proportion of patients with a DCB and 95% credible interval.

Tyrosine Kinase Inhibitor (TKI) Cohort: Proportion of Participants With Major Pathologic Response (MPR)
After surgical resection (approximately study Week 8)

MPR is defined as ≤ 10% residual viable tumor cells as scored by local pathologists.

Checkpoint Inhibitor (CPI) Cohort: Pathological Complete Response (pCR)
After surgical resection (approximately study Week 8)

Scored by local pathologists; defined as lack of any viable tumor cells on review of hematoxylin and eosin (H\&E) slides after complete evaluation of a resected lung cancer specimen including all sampled regional lymph nodes.

KRAS G12C Cohort: Percentage of Participants With 3-5 Grade Adverse Events (AEs)
After surgical resection (approximately study Week 8)
KRAS G12C Cohort: Percentage of Participants Without Delays of Surgery due to Treatment-related AEs as Reported by the Investigator
After surgical resection (approximately study Week 8)
Progression Free Survival (PFS) as Assessed by the Investigator According to Response Evaluation Criteria In Solid Tumors v1.1 (RECIST v1.1)
From randomization to the first occurrence of disease progression or death from any cause, until 330 PFS events were observed (approx. 4.3 years for MGT Cat 1 and 3.4 years for Chemotherapy Cat 1).

This efficacy objective was to evaluate the efficacy of MGT vs platinum chemotherapy in term of PFS in participants with CUP whose best response to 3 cycles of platinum induction chemotherapy was assessed CR, PR, or SD.

Cohort A: Percentage of Participants with Confirmed Objective Response as Assessed by the Investigator Based on the Response Evaluation Criteria in Solid Tumors (RECIST) Version (v) 1.1
Baseline up to disease progression or death (up to approximately 6 years)
Cohort B: Percentage of Participants with Confirmed Objective Response as Assessed by the Investigator Based on RECIST v1.1
Baseline up to disease progression or death (up to approximately 6 years)
Cohort C: Progression Free Survival (PFS) as Assessed by the Investigator Based on RECIST v1.1 in bTMB PP1
Baseline up to disease progression or death (up to approximately 6 years)
Cohort D: Percentage of Participants with Confirmed Objective Response as Assessed by the Investigator Based on RECIST v1.1
Baseline up to disease progression or death (up to approximately 6 years)
Cohort E: Time in Response (TIR) as Assessed by the Investigator Based on RECIST v1.1
Month 12
Cohort F: Investigator-Assessed Objective Response Rate (ORR) Based on RECIST v1.1
Baseline up to disease progression or death (up to approximately 6 years)
Cohort G: Incidence of Adverse Events (AEs)
Baseline to last dose of study treatment + 30 days or until initiation of new anticancer therapy, whichever occurs first (up to approximately 6 years)
Objective Response Rate (ORR)
Up to 2 years

ORR is defined as the percentage of participants with complete response (CR) or partial response (PR) assessed by the investigator using the Response Evaluation Criteria in Solid Tumors (RECIST), v.1.1. CR is defined as disappearance of all target and non-target lesions and no new lesions, and all pathological lymph nodes must have decreased to \<10 mm in short axis. PR is defined as at least a 30% decrease in the sum of diameters of target lesions (taking as reference the baseline sum diameters), no progression in non-target lesions, and no new lesions.

Incidence of Participants with Dose-Limited Toxicities (DLTs)
Cycle 1 (cycle length = 28 days)
Percentage of Participants with Adverse Events
Up to 10 years
Plasma Concentration of Alectinib
Up to 10 years
Plasma Concentration of Alectinib Metabolite (M4)
Up to 10 years
Confirmed Objective Response Rate (ORR): Defined as the Proportion of Participants with Complete Response (CR) or Partial Response (PR) on two Consecutive Occasions >/= 4 Weeks Apart, as Determined by Blinded Independent Central Review (BICR)
Up to 10 years
Maximum Observed Plasma Concentration (Cmax) of Total Alectinib
Predose (0 hour), and at 1, 2, 4, 6, 8, 10, 12, 18, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, and 240 hours postdose (Dosing day = Day 1)

Total alectinib = unbound alectinib plus alectinib bound to plasma proteins

Cmax of Unbound Alectinib
Predose (0 hour), and at 1, 2, 4, 6, 8, 10, 12, 18, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, and 240 hours postdose (Dosing day = Day 1)
Area Under the Plasma Concentration-Time Curve From Time 0 Extrapolated to Infinity (AUC 0-inf) for Total Alectinib
Predose (0 hour), and at 1, 2, 4, 6, 8, 10, 12, 18, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, and 240 hours postdose (Dosing day = Day 1)

Total alectinib = unbound alectinib plus alectinib bound to plasma proteins. AUC 0-inf = Area under the plasma concentration versus time curve (AUC) from time zero (pre-dose) to extrapolated infinite time (0-inf). It is obtained from AUC 0-t plus AUC t-inf.

AUC 0-inf for Unbound Alectinib
Predose (0 hour), and at 1, 2, 4, 6, 8, 10, 12, 18, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, and 240 hours postdose (Dosing day = Day 1)

AUC 0-inf = AUC from time zero (pre-dose) to extrapolated infinite time (0-inf). It is obtained from AUC 0-t plus AUC t-inf.

Area Under the Plasma Concentration-Time Curve From Time 0 to the Last Measureable Concentration (AUC 0-last) for Total Alectinib
Predose (0 hour), and at 1, 2, 4, 6, 8, 10, 12, 18, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, and 240 hours postdose (Dosing day = Day 1)

Total alectinib = unbound alectinib plus alectinib bound to plasma proteins

AUC 0-last for Unbound Alectinib
Predose (0 hour), and at 1, 2, 4, 6, 8, 10, 12, 18, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, and 240 hours postdose (Dosing day = Day 1)
Percentage of Participants with Dose-Limiting Toxicities (DLTs)
28 days
Recommended Phase II Dose (RP2D) of Atezolizumab and Erlotinib
28 days
Recommended RP2D of Atezolizumab and Alectinib
28 days
Area Under the Plasma Concentration-Time Curve From Time Zero to Extrapolated Infinite Time (AUC[0-inf]) of Alectinib
Predose (0 hour), 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 18, 24, 36, 48, 60, 72, and 96 hours postdose

AUC(0-inf) is the area under the alectinib plasma concentration versus time curve (AUC) from time zero (pre-dose) to extrapolated infinite time (0-inf). AUC is a measure of the plasma concentration of a drug over time. AUC(0-inf) is presented in nanogram times (\*) hour per milliliter (ng\*hour/mL).

Area Under the Plasma Concentration-Time Curve From Time Zero to Last Measurable Concentration (AUC[0-last]) of Alectinib
Predose (0 hour), 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 18, 24, 36, 48, 60, 72, and 96 hours postdose

AUC(0-last) is the area under the alectinib plasma concentration versus time curve from time zero to the time of last measured concentration of alectinib. AUC is a measure of the plasma concentration of a drug over time. AUC(0-last) is presented in ng\*hour/mL.

Maximum Observed Plasma Concentration (Cmax) of Alectinib
Predose (0 hour), 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 18, 24, 36, 48, 60, 72, and 96 hours postdose

Cmax is the maximum observed plasma alectinib concentration, presented in nanogram per milliliter (ng/mL).

Elimination: Amount of drug excreted in urine/feces over the study period
Days 11 to 15
Pharmacokinetics: Bioavailability (Area under the plasma concentration-time curve [AUC]) after administration of RO5424802
Days 1 to 25
Number of Participants With Dose Limiting Toxicities (DLTs): Phase I
Throughout Cycle 1 of Phase I (21 days)

The DLTs were defined as any which included Grade 4 thrombocytopenia or Grade 3 thrombocytopenia with bleeding or Grade 4 neutropenia continuing for greater than equal to (\>=) 7 consecutive days, non-hematological toxicity of Grade 3 or higher (excluding transient electrolyte abnormalities, diarrhea, nausea, and vomiting that recovers to Grade 2 or lower with appropriate treatment and participants having Grade 2 aspartate transaminase (AST) and/or alanine transaminase (ALT) at baseline must have Grade 3 AST/ALT for 7 days or Grade 4 AST/ALT to be considered a DLT), and adverse events (AEs) that required suspension of treatment for a total of \>=7 days which the Investigator could not rule out as been related to alectinib.

Recommended Phase II Dose (RP2D): Phase I
Throughout Cycle 1 of Phase I (21 days)

RP2D was defined as the highest dose with acceptable toxicity as determined from Phase I of the study.

Percentage of Participants With Objective Response According to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) by Independent Review Committee (IRC): Phase II
Cycle 1 Day 1 up to 194 weeks (assessed at every 6 weeks from Cycle 1 Day 1, at Cycles 2, 4, and 6 between Days 14-21, and every 3 cycles thereafter) (1 cycle = 21 days)

Percentage of participants with objective response as assessed by IRC was defined as the percentage of responders in the response evaluable population, where responders were defined as participants determined to have a best overall response of complete response (CR) or partial response (PR) based on the RECIST v1.1 criteria. CR: disappearance of all target and non-target lesions (TLs) and normalization of tumor markers. Pathological lymph nodes must have short axis measures less than (\<) 10 millimeter (mm). PR: at least a 30 percent (%) decrease in the sum of measures (longest diameter for tumor lesions and short axis measure for nodes) of TLs, taking as reference the baseline sum of diameters. CR and PR were to be confirmed by repeat assessments \>=4 weeks after initial documentation. Clopper-Pearson method was used to calculate 95% confidence interval (CI).

Recommended Phase 2 Dose (RP2D) of Alectinib
Cycle 1 (up to 28 days)

RP2D was to be determined based on the safety and tolerability profile of the study treatment.

Percentage of Participants With Dose Limiting Toxicities (DLTs)
Cycle 1 (up to 28 days)

DLTs were to be assessed based on the National Cancer Institute-Common Terminology Criteria for Adverse Events version 4.3 (NCI-CTCAE v 4.3). DLTs: drug-related toxicities that meet any one of the following criteria: Grade 4 thrombocytopenia; Grade 3 thrombocytopenia with bleeding; Grade 4 neutropenia continuing for greater than or equal to (\>/=) 7 consecutive days or neutropenic fever; Non-hematological toxicity of Grade 3 or higher; Adverse events that require interruption of treatment for a total of \>/=7 days.

Percentage of Participants Achieving Objective Response (Complete Response [CR] or Partial Response [PR]) as Assessed by Independent Radiological Review Committee (IRC) in Response Evaluable (RE) Population
Baseline; assessments every 8 weeks post-baseline until progressive disease, unacceptable toxicity, consent withdrawal, death, other reason deemed by investigator, or last tumor assessment (up to approximately 2.5 years)

Tumor response was assessed by IRC according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1). Objective response was defined as percentage of participants with a CR or PR that was confirmed by repeat assessments \>/=4 weeks after initial documentation. CR was defined as disappearance of all target, non-target lesions; normalization of tumor marker level; and reduction in all lymph nodes size to less than (\<) 10 millimeters (mm). PR was defined as \>/=30 percent (%) decrease in the sum of diameters (SoD) of target lesions (taking as reference the baseline SoD). The 95% confidence interval (CI) was computed using Clopper-Pearson method.

Percentage of Participants Achieving Objective Response (CR or PR) as Assessed by IRC in Chemotherapy-Pretreated Participants
Baseline; assessments every 8 weeks post-baseline until progressive disease, unacceptable toxicity, consent withdrawal, death, other reason deemed by investigator, or last tumor assessment (up to approximately 2.5 years)

Tumor response was assessed by IRC according to RECIST v1.1. Objective response was defined as percentage of participants with a CR or PR that was confirmed by repeat assessments \>/=4 weeks after initial documentation. CR was defined as disappearance of all target, non-target lesions; normalization of tumor marker level; and reduction in all lymph nodes size to \<10 mm. PR was defined as \>/=30% decrease in the SoD of target lesions (taking as reference the baseline SoD). The 95% CI was computed using Clopper-Pearson method.

Secondary Endpoints

Incidence, Type, and Severity of AEs With Onset up to 28 Days After the Last Dose of Study Treatment or Until Last on Site/Discontinuation Visit, Whichever Comes First
From first dose to up to approximately 2 years
Time to Central Nervous System (CNS) Progression, as Determined by BICR per RECIST v1.1
From randomization to the first occurrence of disease progression in the CNS (up to 3 years)
Distant Metastasis-free Survival (DMFS), as Determined by BICR per RECIST v1.1
From randomization to the first occurrence of distant metastasis or death, whichever occurs first (up to 3 years)
Unlock Study Endpoints

Study Design & Arms

AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Cohort B1EXPERIMENTALParticipants will receive alectinib in combination with a platinum-based chemotherapy for up to 4 cycles (cycle length = 3 weeks), followed by alectinib monotherapy for up to 2 years.
Cohort A1: Anaplastic Lymphoma Kinase (ALK)-positive (Alectinib Arm)EXPERIMENTALParticipants will receive alectinib 600 milligrams (mg) orally twice daily until completion of treatment period (3 years), or until disease progression, unacceptable toxicity, participant or physician decision to discontinue, or death, whichever occurs first
Cohort A1: ALK-positive (Durvalumab Arm)ACTIVE_COMPARATORParticipants will receive 1500 mg of intravenous (IV) durvalumab every 4 weeks (Q4W) until completion of treatment period (1 year) or until disease progression, unacceptable toxicity, participant or physician decision to discontinue, or death, whichever occurs first
Cohort A2: ROS Proto-oncogene 1 (ROS 1)-positive (Entrectinib Arm)EXPERIMENTALParticipants will receive entrectinib 600 mg orally once daily until completion of treatment period (3 years), or until disease progression, unacceptable toxicity, participant or physician decision to discontinue, or death, whichever occurs first. Cohort A2 has been closed to enrollment.
Cohort A2: ROS 1-positive (Durvalumab Arm)ACTIVE_COMPARATORParticipants will receive 1500 mg of IV durvalumab Q4W until completion of treatment period (1 year) or until disease progression, unacceptable toxicity, participant or physician decision to discontinue, or death, whichever occurs first Cohort A2 has been closed to enrollment.
AlectinibEXPERIMENTAL -
Platinum-Based ChemotherapyACTIVE_COMPARATOR -
CrizotinibEXPERIMENTALParticipants will receive crizotinib at the same dose and schedule and according to the same administration guidelines as they received at the time of discontinuation from the parent trial.
Premetrexed/DocetaxelACTIVE_COMPARATORParticipants will receive chemotherapy with either pemetrexed (500 milligrams per square meter \[mg/m\^2\] of body surface area) or docetaxel (75 mg/m\^2) intravenously.
Treatment Arm 01: AlectinibEXPERIMENTALThis alectinib treatment arm is for adult, paediatric and teenage/young adult (TYA) patients with ALK-positive cancers.
ALK Cohort (Enrolment Closed)EXPERIMENTALParticipants will receive up to 8 weeks of alectinib neoadjuvant treatment before undergoing surgical resection per standard of care (SOC). All participants that undergo surgical resection and whose tumors have pathological response or lack radiographic progression will be eligible for the adjuvant treatment phase with alectinib. Adjuvant therapy will consist of 4 cycles of chemotherapy followed by up to 2 years of alectinib. Enrolment Closed.
ROS 1 Cohort (Enrolment Closed)EXPERIMENTALParticipants will receive up to 8 weeks of entrectinib neoadjuvant treatment before undergoing surgical resection per SOC. All participants that undergo surgical resection and whose tumors have pathological response or lack radiographic progression will be eligible for the adjuvant treatment phase with entrectinib. Adjuvant therapy will consist of 4 cycles of chemotherapy followed by up to 2 years of entrectinib. Enrolment Closed.
NTRK Cohort (Enrolment Closed)EXPERIMENTALParticipants will receive up to 8 weeks of entrectinib neoadjuvant treatment before undergoing surgical resection per SOC. All participants that undergo surgical resection and whose tumors have pathological response or lack radiographic progression will be eligible for the adjuvant treatment phase with entrectinib. Adjuvant therapy will consist of 4 cycles of chemotherapy followed by up to 2 years of entrectinib. Enrolment Closed.
BRAF Cohort (No Participants Enrolled, Cohort Closed)EXPERIMENTALParticipants will receive up to 8 weeks of vemurafenib plus cobimetinib neoadjuvant treatment before undergoing surgical resection per SOC. All participants that undergo surgical resection and whose tumors have pathological response or lack radiographic progression will be eligible for the adjuvant treatment phase with vemurafenib plus cobimetinib. Adjuvant therapy will consist of 4 cycles of chemotherapy followed by up to 2 years of of vemurafenib plus cobimetinib. Cohort closed.
RET Cohort (Cohort closed)EXPERIMENTALParticipants will receive up to 8 weeks of pralsetinib neoadjuvant treatment before undergoing surgical resection per SOC. All participants that undergo surgical resection and whose tumors have pathological response or lack radiographic progression will be eligible for the adjuvant treatment phase with pralsetinib. Adjuvant therapy will consist of 4 cycles of chemotherapy followed by up to 2 years of pralsetinib. Cohort closed.
PD-L1 Cohort (Enrolment Closed)EXPERIMENTALParticipants with positive programmed death-ligand 1 (PD-L1) in ≥1% tumor cells will receive 4 cycles of atezolizumab neoadjuvant treatment. During neoadjuvant Cycle 1 of atezolizumab, participants will also receive low-dose stereotactic body radiation therapy (SBRT) (8 gray \[Gy\] X 3). Adjuvant treatment consists of SOC treatment as determined by the investigator, per National Comprehensive Cancer Network (NCCN) guidelines. Enrolment Closed.
KRAS G12C CohortEXPERIMENTALParticipants will receive up to 8 weeks of divarasib as neoadjuvant treatment before undergoing surgical resection per SOC. PD-L1 negative participants whose tumors have pathological response or lack radiographic progression will be have the option of continuing divarasib alone for up to 3 years or 1-4 cycles of SOC chemotherapy followed by divarasib for 3 years as adjuvant therapy. For participants who test positive PD-L1, they will have the option to receive 1-4 cycles of SOC chemotherapy followed by atezolizumab for up to 16 cycles or SOC alone.
Molecularly-Guided TherapyEXPERIMENTALParticipants will be assigned to molecularly-guided therapy based on genomic profile.
Cohort A: Alectinib 600 Milligrams (mg)EXPERIMENTALThis cohort includes participants with anaplastic lymphoma kinase (ALK) positive NSCLC. Participants will receive alectinib 600 mg orally twice in a day (BID) until disease progression, unacceptable toxicity, withdrawal of consent or death. Enrollment to Cohort A is complete.
Cohort B: Dose Finding Phase (DFP) AlectinibEXPERIMENTALThis cohort includes participants with rearranged during transfection (RET) positive NSCLC. Participants may receive alectinib 900 or 1200 mg orally BID until disease progression, unacceptable toxicity, withdrawal of consent or death if the recommended phase 2 dose (RP2D) is not established in any other clinical study. Participants may receive 750 mg or 600 mg, if it is unsafe to pursue the higher starting dose. Enrollment to Cohort B is complete.
Cohort B: Dose Expansion Phase (DEP) AlectinibEXPERIMENTALThis cohort includes participants with RET positive NSCLC. Participants will receive alectinib at the RP2D established in the DFP of Cohort B or a separate clinical study. Participants will continue receiving study treatment until disease progression, unacceptable toxicity, withdrawal of consent or death. Enrollment to Cohort B is complete.
Cohort C: Atezolizumab 1200 mgEXPERIMENTALThis cohort includes participants with bTMB positive NSCLC. Participants will receive atezolizumab at a dose of 1200 mg administered by IV infusion every 21 days (Q21D) until disease progression, loss of clinical benefit, unacceptable toxicity, withdrawal of consent or death. Enrollment to Cohort C is complete.
Cohort C: Pemetrexed, Cisplatin or CarboplatinACTIVE_COMPARATORThis cohort includes participants with bTMB positive, non-squamous NSCLC. Participants will receive 4 or 6 cycles of treatment, with each cycle being 21 days in duration. Carboplatin at a dose of area under the concentration-time curve (AUC) of 5 or 6 IV or cisplatin at a dose of 75 milligrams per meter square (mg/m\^2) IV on Day 1 of each cycle combined with pemetrexed at a dose of 500 mg/m\^2 IV on Day 1 of each cycle. Pemetrexed may be continued as maintenance therapy every 21 days (Q21D) as per local standard of care. Enrollment to Cohort C is complete.
Cohort C: Gemcitabine, Cisplatin or CarboplatinACTIVE_COMPARATORThis cohort includes participants with bTMB positive, squamous NSCLC. Participants will receive 4 or 6 cycles of treatment, with each cycle being 21 days in duration. Gemcitabine 1250 mg/m\^2 IV on Days 1 and 8 of every cycle and cisplatin 75 mg/m\^2 IV on Day 1 Q21D or gemcitabine 1000 mg/m\^2 IV on Days 1 and 8 of every cycle and carboplatin AUC 5 IV on Day 1 Q21D. Enrollment to Cohort C is complete.
Cohort D: Entrectinib 600 Milligrams (mg)EXPERIMENTALThis cohort includes participants with c-ros oncogene 1 positive (ROS1+) NSCLC. Participants will receive entrectinib 600 mg orally once a day (QD) until disease progression, unacceptable toxicity, withdrawal of consent or death. Enrollment to Cohort D is complete.
Cohort E: Atezolizumab, Vemurafenib, and CobimetinibEXPERIMENTALThis cohort includes participants with BRAF V600 mutation. Participants will receive: atezolizumab 1680 mg IV Q4W after the run-in period; cobimetinib 60 mg orally (PO) QD on Days 1-21 of each cycle during the run-in and triple-combination periods; and vemurafenib 960 mg PO twice daily (BID) on Days 1-21 of the initial run-in period, then 720 mg PO BID on Days 1-22 of the initial run-in period and on Days 1-28 of each cycle during the triple-combination period. Enrollment to Cohort E is complete.
Cohort F: Atezolizumab, Bevacizumab, Carboplatin, and PemetrexedEXPERIMENTALThis cohort includes participants with EGFR exon 20+ NSCLC. Participants will receive atezolizumab + bevacizumab + carboplatin + pemetrexed for 4 or 6 induction cycles (cycle = 21 days). After induction therapy, participants will continue maintenance treatment with atezolizumab + bevacizumab + pemetrexed until disease progression, unacceptable toxicity, withdrawal of consent, or death. Enrollment to Cohort F is complete.
Cohort G: Divarasib or DocetaxelEXPERIMENTALExperimental: Cohort G: GDC-6036 or Docetaxel This cohort includes participants with KRAS G12C mutation. Participants will receive GDC-6036 PO QD or IV docetaxel Q3W (75 mg/m\^2) until disease progression or unacceptable toxicity New participants will no longer receive docetaxel.
Cohort Z: Natural History CohortNO_INTERVENTIONParticipants with genomic profiles of interest that are not enrolled in the other cohorts will enter into natural history follow-up.
ALK-Fusion PositiveEXPERIMENTALPart 1 is a dose-confirmation phase to confirm the recommended phase 2 dose (RP2D). In Parts 2 and 3, participants will receive alectinib at the RP2D on Days 1-28 of each 28-day cycle
Alectinib: Moderate Hepatic ImpairmentEXPERIMENTALParticipants with moderate hepatic impairment (based on Child-Pugh score) will receive alectinib at a single oral dose of 300 milligrams (mg) on Day 1.
Alectinib: Severe Hepatic ImpairmentEXPERIMENTALParticipants with severe hepatic impairment (based on Child-Pugh score) will receive alectinib at a single oral dose of 300 mg on Day 1.
Alectinib: Normal Hepatic FunctionEXPERIMENTALParticipants with normal hepatic function will receive alectinib at a single oral dose of 300 mg on Day 1.
Stage 1: Alectinib and AtezolizumabEXPERIMENTALIn Stage 1, starting dose of atezolizumab will be 1200 mg IV q3w administered on Day 8 of Cycle 1 and on Day 1 (21-day cycle) of each cycle thereafter along with alectinib at a starting dose of 600 mg PO BID for 28 consecutive days during Cycle 1 and on Days 1-21 of each cycle thereafter; unless maximum tolerable dose (MTD) is exceeded. The combination will be given to treatment-naive participants with ALK-positive, locally advanced or metastatic NSCLC.
Stage 1: Erlotinib and AtezolizumabEXPERIMENTALIn Stage 1, starting dose of atezolizumab will be 1200 mg IV q3w administered on Day 8 of Cycle 1 and on Day 1 (21-day cycles) of each cycle thereafter along with erlotinib at a starting dose of 150 mg PO QD, for 28 consecutive days during Cycle 1 and on Days 1-21 of each cycle thereafter; unless MTD is exceeded. The combination will be given to participants with EGFR TKI treatment-naive, locally advanced or metastatic NSCLC.
Stage 2: Alectinib and AtezolizumabEXPERIMENTALIn Stage 2, participants received the RP2D on the basis of the MTD or maximum allowed dose (MAD) of the combination treatment established in Stage 1. Treatment-naive participants with ALK-positive, locally advanced or metastatic NSCLC will be included.
Stage 2: Erlotinib and AtezolizumabEXPERIMENTALIn Stage 2, participants received the RP2D on the basis of the MTD or MAD of the combination treatment established in Stage 1. Previously untreated (or with one prior treatment that was not an EGFR TKI), EGFR mutation positive, locally advanced or metastatic NSCLC participants will be included.
Ro542-4802/F03;Ro542-4802/F07;Ro542-4802/F14;Ro542-4802/F08EXPERIMENTALParticipants will receive Ro542-4802/F03 (containing 50% SLS) capsules orally on Day 1 of first intervention period; then Ro542-4802/F07 (containing 25% SLS) capsules orally on Day 1 of second intervention period; then Ro542-4802/F14 (containing 12.5% SLS) capsules orally on Day 1 of third intervention period; followed by Ro542-4802/F08 (containing 3% SLS) capsules orally on Day 1 of fourth intervention period during both fasted (Part 1) and fed (Part 2) conditions. A washout period of at least 10 days will be maintained between each period.
Ro542-4802/F07;Ro542-4802/F08;Ro542-4802/F03;Ro542-4802/F14EXPERIMENTALParticipants will receive Ro542-4802/F07 (containing 25% SLS) capsules orally on Day 1 of first intervention period; then Ro542-4802/F08 (containing 3% SLS capsules orally on Day 1 in second intervention period; then Ro542-4802/F03 (containing 50% SLS) (containing 12.5% SLS) capsules orally on Day 1 of third intervention period; followed by Ro542-4802/F14 (containing 12.5% SLS) capsules orally on Day 1 of the fourth intervention period during both fasted (Part 1) and fed (Part 2) conditions. A washout period of at least 10 days will be maintained between each period.
Ro542-4802/F08;Ro542-4802/F14;Ro542-4802/F07;Ro542-4802/F03EXPERIMENTALParticipants will receive Ro542-4802/F08 (containing 3% SLS) capsules orally on Day 1 of first intervention period; then Ro542-4802/F14 (containing 12.5% SLS) capsules orally on Day 1 in second intervention period; then Ro542-4802/F07 (containing 25% SLS) capsules orally on Day 1 of third intervention period; followed by Ro542-4802/F03 (containing 50% SLS) capsules orally on Day 1 of the fourth intervention period during both fasted (Part 1) and fed (Part 2) conditions. A washout period of at least 10 days will be maintained between each period.
Ro542-4802/F14;Ro542-4802/F03;Ro542-4802/F08;Ro542-4802/F07EXPERIMENTALParticipants will receive Ro542-4802/F14 (containing 12.5% SLS) capsules orally on Day 1 of first intervention period; then Ro542-4802/F03 (containing 50% SLS) capsules orally on Day 1 in second intervention period; then Ro542-4802/F08 (containing 3% SLS) capsules orally on Day 1 of third intervention period; followed by Ro542-4802/F07 (containing 25% SLS) capsules orally on Day 1 of the fourth intervention period during both fasted (Part 1) and fed (Part 2) conditions. A washout period of at least 10 days will be maintained between each period.
RO5424802EXPERIMENTAL -
Healthy subjectsEXPERIMENTAL -
Alectinib: Phase I (Dose Escalation)EXPERIMENTALParticipants will receive escalating doses of alectinib capsules orally until disease progression, death or withdrawal for any other reasons.
Alectinib (Phase II: RP2 dose)EXPERIMENTALParticipants will receive recommended Phase II dose as determined from Phase I until disease progression, death or withdrawal for any other reasons.

Interventions

NameTypeDescription
AlectinibDRUGParticipants will receive oral alectinib twice daily (BID) for up to 2 years.
CisplatinDRUGParticipants will receive intravenous (IV) cisplatin on Day 1 of each cycle for up to 4 cycles (cycle length = 3 weeks).
CarboplatinDRUGParticipants will receive IV carboplatin on Day 1 of each cycle for up to 4 cycles (cycle length = 3 weeks).
PemetrexedDRUGParticipants will receive IV pemetrexed on Day 1 of each cycle for up to 4 cycles (cycle length = 3 weeks).
EntrectinibDRUGParticipants will receive oral entrectinib once daily, with or without food.
DurvalumabDRUGParticipants will receive durvalumab, IV Q4W.
AlectnibDRUGParticipants will receive alectinib 600 mg orally BID until completion of treatment period (24 months) or recurrence of disease , unacceptable toxicity, withdrawal of consent or death, whichever occurs first.
VinorelbineDRUGParticipants will receive Vinorelbine 25 mg/m\^2 IV on Days 1 and 8 Q21D until completion of treatment period (4 cycles), recurrence of disease, unacceptable toxicity, withdrawal of consent, or death, whichever occurs first.
GemcitabineDRUGParticipants will receive Gemcitabine 1250 mg/m\^2 on Days 1 and 8 Q21D IV until completion of treatment period (4 cycles), recurrence of disease, unacceptable toxicity, withdrawal of consent, or death, whichever occurs first.
CrizotinibDRUGCrizotinib capsules 250 mg BID orally until no further clinical benefit is to be expected, unacceptable toxicity, availability of commercial supply, withdrawal of consent, or death, whichever occurs first.
DocetaxelDRUGParticipants will receive docetaxel at a dose of 75 mg/m\^2 of body surface area intravenously every 3 weeks, until disease progression, unacceptable toxicity, withdrawal of consent or death.
VemurafenibDRUGParticipants will receive oral vemurafenib BID.
CobimetinibDRUGParticipants will receive oral cobimetinib daily.
PralsetinibDRUGParticipants will receive oral pralsetinib daily.
AtezolizumabDRUGAtezolizumab will be administered by intravenous (IV) infusion.
SBRTDRUGParticipants will receive SBRT given concurrently, starting with the first dose of atezolizumab.
ResectionPROCEDUREParticipants will receive surgical resection of the primary tumor along with selected lymph nodes per SOC.
ChemotherapyDRUGParticipants will receive SOC chemotherapy as determined by the treating physician.
DivarasibDRUGParticipants in the KRAS G12C cohort will receive oral divarasib for approximately 8 weeks until the day before surgery as neoadjuvant therapy up to 3 years as adjuvant therapy.
VismodegibDRUGVismodegib will be administered orally at the label-recommended dose (150 mg) once daily until loss of clinical benefit or unacceptable toxicity, through the end of the study (approximately 70 months).
IpatasertibDRUGIpatasertib will be administered orally at the label-recommended dose (400 mg) once daily on Days 1-21 of each 28-day Cycle in combination with paclitaxel, and as monotherapy after the final administration of paclitaxel, until loss of clinical benefit or unacceptable toxicity, through the end of the study (approximately 70 months).
OlaparibDRUGOlaparib will be administered orally at the label-recommended dose (400 mg) twice daily until loss of clinical benefit or unacceptable toxicity, through the end of the study (approximately 70 months).
ErlotinibDRUGErlotinib will be administered orally in combination with Bevacizumab at the label recommended dose (150 mg) once daily until loss of clinical benefit or unacceptable toxicity, through the end of the study (approximately 70 months)
BevacizumabDRUGBevacizumab will be administered intravenously at 15mg/kg every 3 weeks in combination with Erlotinib until loss of clinical benefit or unacceptable toxicity, through the end of the study (approximately 70 months)
Trastuzumab Subcutaneous (SC)DRUGTrastuzumab will be administered subcutaneously, 600 mg every 3 weeks, in combination with Pertuzumab and chemotherapy, until loss of clinical benefit or unacceptable toxicity, through the end of the study (approximately 70 months)
PertuzumabDRUGPertuzumab will be initially be administered intravenously, 840 mg, followed by 420 mg every 3 weeks, in combination with Trastuzumab and chemotherapy, until loss of clinical benefit or unacceptable toxicity, through the end of the study (approximately 70 months)
PaclitaxelDRUGPaclitaxel will be administered intravenously, 175 mg/m\^2, once every 3 weeks for up to 9 cycles (Cycle = 21 days) in some combination with the following: Carboplatin, Ipatasertib, Atezolizumab, Pertuzumab, and Trastuzumab SC
IvosidenibDRUGIvosidenib will be administered orally at the label-recommended dose (500mg) once daily across a 28-day treatment cycle until loss of clinical benefit or unacceptable toxicity.
PemigatinibDRUGPemigatinib will be administered orally at the label-recommended dose (13.5mg) once daily across a 21-day treatment cycle until loss of clinical benefit or unacceptable toxicity.
Ro542-4802/F03 (Reference)DRUGParticipants will receive Ro542-4802/F03 (containing 50% SLS) 600 mg capsules orally on Day 1.
Ro542-4802/F07 (Test)DRUGParticipants will receive Ro542-4802/F07 (containing 25% SLS) 600 mg capsules orally on Day 1.
Ro542-4802/F08 (Test)DRUGParticipants will receive Ro542-4802/F08 (containing 3% SLS) 600 mg capsules orally on Day 1.
Ro542-4802/F14 (Test)DRUGParticipants will receive Ro542-4802/F14 (containing 12.5% SLS) 600 mg capsules orally on Day 1.
RO5424802DRUGSingle oral doses followed by IV or oral administration of a 14C-labeled tracer
rifampinDRUGMultiple doses Days 8-16 and Days 17-20
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites11

Inclusion Criteria: * Complete resection of the primary NSCLC with negative margins * Confirmed stage II to select stage IIIB (T3N2) NSCLC of non-squamous (adenocarcinoma) histology * Eastern cooperative oncology group (ECOG) performance status of 0 or 1 * Documented ALK fusion Exclusion Criteria:...

Countries:AustraliaBrazilChileChinaItalySouth KoreaUnited StatesBelgiumColombiaFranceGermanyJapanMexicoPolandSingaporeSwedenTaiwanThailandUnited KingdomAustriaBelarusBosnia and HerzegovinaDenmarkEgyptGreeceHungaryIsraelKazakhstanNorth MacedoniaRomaniaRussiaSpainTurkey (Türkiye)UkraineHong KongBulgariaNorwayPortugalSlovakiaCanadaCosta RicaGuatemalaNew ZealandSerbiaSwitzerlandCroatiaCzechiaEstoniaFinlandIrelandLatviaNetherlandsPeruArgentinaPanamaLuxembourg
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Recent Changes (Last 90 Days)

LOWOct 14, 2026NCT03456076lastUpdatePostDate: changed
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MEDIUMSep 19, 2026NCT06624059TRIAL_REMOVED: changed
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LOWSep 10, 2026NCT04302025lastUpdatePostDate: changed
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MEDIUMSep 3, 2026NCT03178552primaryCompletionDate: changed
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HIGHAug 19, 2026NCT06624059Status: ACTIVE_NOT_RECRUITING → COMPLETED
HIGHAug 19, 2026NCT06624059Status: ACTIVE_NOT_RECRUITING → COMPLETED
MEDIUMAug 14, 2026NCT04774718Status: RECRUITING → ACTIVE_NOT_RECRUITING
MEDIUMAug 14, 2026NCT04774718Status: RECRUITING → ACTIVE_NOT_RECRUITING
LOWAug 11, 2026NCT04302025lastUpdatePostDate: changed
LOWAug 11, 2026NCT04302025lastUpdatePostDate: changed

Frequently asked questions about RO5424802

What is RO5424802?

RO5424802 is an investigational small molecule kinase inhibitor developed by Roche Holding AG (ticker RHHBY). It is also known as alectinib. The compound has been studied in Phase 1 clinical trials, including bioequivalence, elimination, pharmacokinetic, and drug interaction studies conducted in healthy volunteers.

What does RO5424802 target?

RO5424802 targets ALK, a kinase enzyme. It is a small molecule kinase inhibitor designed to inhibit ALK activity. This mechanism underlies its investigation as a targeted therapy, and the compound has been evaluated in Phase 1 studies including pharmacokinetic and drug interaction assessments.

Who is developing RO5424802?

RO5424802 is being developed by Roche Holding AG, which trades under the ticker RHHBY. Roche is the sponsor of the clinical studies evaluating this compound, including the Phase 1 trials listed on ClinicalTrials.gov.

What phase is RO5424802 in?

RO5424802 is in Phase 1 clinical development. All three registered trials are Phase 1 studies, and all are completed. The trials include a bioequivalence study, an elimination and metabolism study, and a drug interaction study with rifampin.

What clinical trials is RO5424802 in?

RO5424802 has been studied in three completed Phase 1 trials: NCT02074553, a bioequivalence study of three test formulations versus a reference formulation in healthy volunteers; NCT01981005, an elimination, pharmacokinetics, and metabolism study; and NCT01940510, which examined the effect of multiple doses of rifampin on single-dose pharmacokinetics.

Is RO5424802 the same as alectinib?

Yes, RO5424802 is also known as alectinib. The names Ro542-4802/F03 (Reference) and Ro542-4802/F03 refer to the same compound. Alectinib is the international nonproprietary name for this ALK-targeting small molecule developed by Roche.