Abstract
Rearrangement in the anaplastic lymphoma kinase (ALK) gene is one of the oncogenic drivers in non-small cell lung cancer (NSCLC) patients. Several ALK inhibitors (ALKis) have been developed and have demonstrated their efficacy, however the best treatment strategy for ALK positive NSCLC patients has yet to be determined. Our retrospective study has investigated the outcome of 40 ALK-rearranged NSCLC patients treated with two different sequential strategies in our Institute; a "classical group", treated with crizotinib followed by second or third generation ALKis, and the "experimental group", treated upfront with a second generation ALK inhibitor. The primary endpoints investigated were Progressionfree survival (PFS) and intracranial activity. The analysis has revealed a significant improvement in PFS (p = 0.050) in the experimental group, furthermore none of these patients developed brain metastasis. There was no statistically significant difference in OS, but all patients in the experimental group were still alive after a median follow up of 15 months. Our retrospective analysis suggests that systemic and intracranial efficacy tends to be better in the experimental group; randomized prospective studies could confirm our observations.
| Original language | English |
|---|---|
| Pages (from-to) | 15340-15349 |
| Number of pages | 10 |
| Journal | Oncotarget |
| Volume | 9 |
| Issue number | 20 |
| DOIs | |
| Publication status | Published - Jan 1 2018 |
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Keywords
- ALK inhibitors
- Anaplastic lymphoma kinase (ALK)
- Brain metastasis
- Non-small cell lung cancer
ASJC Scopus subject areas
- Oncology
Cite this
Outcomes of ALK positive lung cancer patients treated with crizotinib or second-generation ALK inhibitor : A monoinstitutional experience. / De Carlo, Elisa; Del Savio, Maria Chiara; Polesel, Jerry; Da Ros, Valentina; Berto, Eleonora; Santarossa, Sandra; Chimienti, Emanuela; Fratino, Lucia; Bearz, Alessandra.
In: Oncotarget, Vol. 9, No. 20, 01.01.2018, p. 15340-15349.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Outcomes of ALK positive lung cancer patients treated with crizotinib or second-generation ALK inhibitor
T2 - A monoinstitutional experience
AU - De Carlo, Elisa
AU - Del Savio, Maria Chiara
AU - Polesel, Jerry
AU - Da Ros, Valentina
AU - Berto, Eleonora
AU - Santarossa, Sandra
AU - Chimienti, Emanuela
AU - Fratino, Lucia
AU - Bearz, Alessandra
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Rearrangement in the anaplastic lymphoma kinase (ALK) gene is one of the oncogenic drivers in non-small cell lung cancer (NSCLC) patients. Several ALK inhibitors (ALKis) have been developed and have demonstrated their efficacy, however the best treatment strategy for ALK positive NSCLC patients has yet to be determined. Our retrospective study has investigated the outcome of 40 ALK-rearranged NSCLC patients treated with two different sequential strategies in our Institute; a "classical group", treated with crizotinib followed by second or third generation ALKis, and the "experimental group", treated upfront with a second generation ALK inhibitor. The primary endpoints investigated were Progressionfree survival (PFS) and intracranial activity. The analysis has revealed a significant improvement in PFS (p = 0.050) in the experimental group, furthermore none of these patients developed brain metastasis. There was no statistically significant difference in OS, but all patients in the experimental group were still alive after a median follow up of 15 months. Our retrospective analysis suggests that systemic and intracranial efficacy tends to be better in the experimental group; randomized prospective studies could confirm our observations.
AB - Rearrangement in the anaplastic lymphoma kinase (ALK) gene is one of the oncogenic drivers in non-small cell lung cancer (NSCLC) patients. Several ALK inhibitors (ALKis) have been developed and have demonstrated their efficacy, however the best treatment strategy for ALK positive NSCLC patients has yet to be determined. Our retrospective study has investigated the outcome of 40 ALK-rearranged NSCLC patients treated with two different sequential strategies in our Institute; a "classical group", treated with crizotinib followed by second or third generation ALKis, and the "experimental group", treated upfront with a second generation ALK inhibitor. The primary endpoints investigated were Progressionfree survival (PFS) and intracranial activity. The analysis has revealed a significant improvement in PFS (p = 0.050) in the experimental group, furthermore none of these patients developed brain metastasis. There was no statistically significant difference in OS, but all patients in the experimental group were still alive after a median follow up of 15 months. Our retrospective analysis suggests that systemic and intracranial efficacy tends to be better in the experimental group; randomized prospective studies could confirm our observations.
KW - ALK inhibitors
KW - Anaplastic lymphoma kinase (ALK)
KW - Brain metastasis
KW - Non-small cell lung cancer
UR - http://www.scopus.com/inward/record.url?scp=85043975117&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85043975117&partnerID=8YFLogxK
U2 - 10.18632/oncotarget.24573
DO - 10.18632/oncotarget.24573
M3 - Article
AN - SCOPUS:85043975117
VL - 9
SP - 15340
EP - 15349
JO - Oncotarget
JF - Oncotarget
SN - 1949-2553
IS - 20
ER -