Treatment discontinuation rates due to adverse events were comparable between the two groups.<h4>Conclusions</h4>In crizotinib-refractory ALK-positive NSCLC, systemic efficacy was not significantly different between brigatinib and alectinib; however, alectinib was associated with more favorable intracranial PFS and ORR, which may be partly explained by differences in prior brain-directed local treatments. The gene discussed is ALK; the disease is non-small cell lung carcinoma.