Abstract: Background Currently, six ALK inhibitors have been approved for first-line treatment of ALK-positive advanced non-small cell lung cancer (NSCLC), yet clinical selection remains challenging. Objective To provide evidence-based guidance for clinical decision-making through a multidimensional evaluation. Methods A comprehensive clinical assessment was conducted, evaluating six ALK inhibitors across five key dimensions: safety, efficacy, pharmaceutical properties, cost-effectiveness, and other attributes. Results All drugs achieved total scores exceeding 75 points, with brigatinib demonstrating the highest overall score (85.5 points). When focusing on the three core dimensions (safety, efficacy, and pharmaceutical properties), lorlatinib performed optimally (70.3 points). Intergenerational analysis revealed that third-generation inhibitors exhibited superior performance in most dimensions. Conclusion This study confirms that each ALK inhibitor has distinct advantages, with third-generation agents showing the most prominent overall benefits. The evaluation results provide crucial guidance for healthcare institutions to select individualized treatment strategies based on clinical needs.

摘要： 背景 目前六种ALK抑制剂已获批用于ALK阳性晚期非小细胞肺癌的一线治疗，但临床选择面临挑战。目的 通过多维度评价为临床用药决策提供循证依据。方法 采用临床综合评价方法，从安全性、有效性、药学特性、经济性和其他属性五个维度对六种ALK抑制剂进行全面评估。结果 所有药物总分均超过75分，其中布格替尼综合评分最高（85.5分）；聚焦安全性、有效性和药学特性三大核心维度时，洛拉替尼表现最优（70.3分）。代际分析显示第三代药物在多数维度优势显著。结论 本研究证实不同ALK抑制剂各具优势，第三代药物整体表现突出，评价结果可为医疗机构根据临床需求选择个体化治疗方案提供重要参考。

关键词: ALK抑制剂, 非小细胞肺癌, 综合评价, 临床合理用药, 个体化治疗