Real-world outcomes according to treatment strategies in ALK-rearranged non-small-cell lung cancer (NSCLC) patients: an Italian retrospective study: Clinical and Translational Oncology

E. Gobbini, R. Chiari, P. Pizzutillo, P. Bordi, L. Ghilardi, S. Pilotto, G. Osman, F. Cappuzzo, F. Cecere, F. Riccardi, V. Scotti, O. Martelli, G. Borra, E. Maiello, A. Rossi, P. Graziano, V. Gregorc, C. Casartelli, C. Sergi, A. Del ConteA. Delmonte, C. Bareggi, D. Cortinovis, P. Rizzo, F. Tabbò, G. Rossi, E. Bria, D. Galetta, M. Tiseo, M. Di Maio, S. Novello

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Anaplastic lymphoma kinase (ALK) rearrangement confers sensitivity to ALK inhibitors (ALKis) in non-small-cell lung cancer (NSCLC). Although several drugs provided an impressive outcome benefit, the most effective sequential strategy is still unknown. We describe outcomes of real-life patients according to the treatment strategy received. Patients: We retrospectively collected 290 ALK rearranged advanced NSCLC diagnosed between 2011 and 2017 in 23 Italian institutions. Results: After a median follow-up of 26 months, PFS for crizotinib and a new generation ALKis were 9.4 [CI 95% 7.9–11.2] and 11.1 months [CI 95% 9.2–13.8], respectively, while TTF were 10.2 [CI 95% 8.5–12.6] and 11.9 months [CI 95% 9.7–17.4], respectively, being consistent across the different settings. The composed outcomes (the sum of PFS or TTF) in patients treated with crizotinib followed by a new generation ALKis were 27.8 months [CI 95% 24.3–33.7] in PFS and 30.4 months [CI 95% 24.7–34.9] in TTF. The median OS from the diagnosis of advanced disease was 39 months [CI 95% 31.8–54.5]. Patients receiving crizotinib followed by a new generation ALKis showed a higher median OS [57 months (CI 95% 42.0–73.8)] compared to those that did not receive crizotinib [38 months (CI 95% 18.6–NR)] and those who performed only crizotinib as target agent [15 months (CI 95% 11.3–34.0)] (P <0.0001). Conclusion: The sequential administration of crizotinib and a new generation ALKis provided a remarkable clinical benefit in this real-life population, being an interesting option to consider in selected patients. © 2019, Federación de Sociedades Españolas de Oncología (FESEO).
Original languageEnglish
Pages (from-to)294-301
Number of pages8
JournalClin. Transl. Oncol.
Volume22
Issue number3
DOIs
Publication statusPublished - 2020

Keywords

  • ALK inhibitors
  • Lung cancer
  • Sequence
  • anaplastic lymphoma kinase
  • brigatinib
  • crizotinib
  • ensartinib
  • entrectinib
  • lorlatinib
  • ALK protein, human
  • antineoplastic agent
  • protein kinase inhibitor
  • adult
  • advanced cancer
  • aged
  • Article
  • cancer diagnosis
  • cancer patient
  • cohort analysis
  • female
  • follow up
  • gene rearrangement
  • human
  • Italy
  • major clinical study
  • male
  • non small cell lung cancer
  • outcome assessment
  • retrospective study
  • comparative study
  • genetics
  • lung tumor
  • middle aged
  • pathology
  • treatment outcome
  • very elderly
  • young adult
  • Adult
  • Aged
  • Aged, 80 and over
  • Anaplastic Lymphoma Kinase
  • Antineoplastic Combined Chemotherapy Protocols
  • Carcinoma, Non-Small-Cell Lung
  • Crizotinib
  • Female
  • Gene Rearrangement
  • Humans
  • Lung Neoplasms
  • Male
  • Middle Aged
  • Protein Kinase Inhibitors
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

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