Chemotherapy Combined with ICIs in First-line Alectinib Failed Patients with ALK-rearranged NSCLC

Prior treatment

• Adverse events (except alopecia of any degree) of CTCAE \> grade 1 due to prior treatment (e.g., adjuvant chemotherapy, radiotherapy, etc.) prior to the first dose.
• History of stroke or intracranial hemorrhage within 6 months prior to the first dose.
• Refractory nausea and vomiting, chronic gastrointestinal disease, difficulty swallowing drugs, or inability to adequately absorb sunvozertinib or anlotinib due to previous bowel resection.
• Live vaccine was given 2 weeks before the first medication.

Other illness

• History of other malignant tumors within 2 years.
• The presence of any severe or poorly controlled systemic disease, including poorly controlled hypertension and active bleeding in the judgment of the investigator.
• Past history of interstitial lung disease, drug-induced interstitial lung disease, radiation pneumonitis requiring steroid therapy or interstitial lung disease with active clinical symptoms, immune pneumonia caused by immunotherapy.
• Hypersensitivity to the test drug and the ingredients.
• Other conditions assessed by the investigator to be unsuitable for participation in the study.

Lab values

• Subjects who have received any of the following treatments must be excluded:
  • Treatment with molecules such as EGFR, VEGFR antibodies within 4 weeks prior to the first dose of study drug.
  • Have received radiation within 14 days prior to the first dose or have not recovered from radiation-related toxicity. Chest and extra-brain palliative radiotherapy, stereotactic radiosurgery, and stereotactic body radiotherapy may be performed 7 days prior to the first dose.

Other

• Patient who do not have the samples for NGS to confirmed ALK status.
• Presence of spinal cord compression or meningeal metastasis.
• Women who are breastfeeding or pregnant.

• ≥18，Advanced Non-small Cell Lung Cancer Confirmed by Histopathology
• ALK -arreaged confirmed by NGS;
• Received first line treatment Alectinib;
• Progressed from first-line alectinib;
• ECOG 0-1;
• Predicted survival ≥ 12 weeks;
• Adequate bone marrow hematopoiesis and organ function;
• Presence of measurable lesions according to RECIST 1.1;
• Subjects with stable brain metastases may be included in the study.
• Understand the requirements and contents of the clinical trial, and provide a signed and dated informed consent form.