ALK Inhibitors or Chemotherapy for Third Line in ALK-positive NSCLC? Real-world Data
© The Author(s) 2022. Published by Oxford University Press..
OBJECTIVES: ALK inhibitors (ALKi) are the standard-of-care treatment for metastatic ALK-rearranged non-small cell lung cancer (NSCLC) in the first- and second-line setting. We conducted a real-world multi-institutional analysis, aiming to compare the efficacy of third-line ALKi versus chemotherapy in these patients.
METHODS: Consecutive ALK-positive metastatic NSCLC patients treated with at least one ALKi were identified in the working databases of 7 Israeli oncology centers (the full cohort). Demographic and clinical data were collected. Patients receiving any systemic treatment beyond 2 ALKi comprised the third-line cohort, whether a third ALKi (group A) or chemotherapy (group B). Groups A and B were compared in terms of overall survival (OS) and time-to-next-treatment line (TNT).
RESULTS: At a median follow-up of 41 months (95% confidence interval [CI]: 32-55), 80 (47.1%) have died. Median OS (mOS) in the full cohort (n = 170) was 52 months (95% CI: 32-65). Number of ALKi (hazard ratio [HR] 0.765; 95% CI: 0.61-0.95; P = .024) and age (HR 1.02, 95% CI: 1.01-1.04, P = .009) significantly associated with OS in the full cohort. The third-line cohort included 40 patients, of which 27 were treated with third ALKi (group A) and 13 treated with chemotherapy (group B). mOS from third-line initiation was 27 months in group A (95% CI: 13-NR) and 13 months for group B (95% CI: 3-NR); the difference was not significant (NS; P = .12). Chemotherapy as first line (HR 0.17, 95% CI: 0.05-0.52, P = .002) and a higher number of ALKi (HR 0.38, 95% CI: 0.20-0.86, P = .011) associated significantly with longer OS of the third-line cohort. TNT was 10 months for group A (95% CI: 5-19) and 3 months for group B (95% CI: 0-NR); the difference was NS (P = .079).
CONCLUSION: We report mature real-world data of more than 4-year mOS in ALK-positive patients. The number of ALKi given was associated with a better outcome. OS and TNT demonstrated a statistically nonsignificant trend for a better outcome in patients receiving a third-line ALKi.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
|---|---|
| Enthalten in: |
The oncologist - 27(2022), 1 vom: 03. Feb., Seite e76-e84 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Moskovitz, Mor [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 20.04.2022 Date Revised 31.05.2022 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1093/oncolo/oyab005 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM338356274 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM338356274 | ||
| 003 | DE-627 | ||
| 005 | 20231226000503.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/oncolo/oyab005 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1127.xml |
| 035 | |a (DE-627)NLM338356274 | ||
| 035 | |a (NLM)35305096 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Moskovitz, Mor |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a ALK Inhibitors or Chemotherapy for Third Line in ALK-positive NSCLC? Real-world Data |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 20.04.2022 | ||
| 500 | |a Date Revised 31.05.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2022. Published by Oxford University Press. | ||
| 520 | |a OBJECTIVES: ALK inhibitors (ALKi) are the standard-of-care treatment for metastatic ALK-rearranged non-small cell lung cancer (NSCLC) in the first- and second-line setting. We conducted a real-world multi-institutional analysis, aiming to compare the efficacy of third-line ALKi versus chemotherapy in these patients | ||
| 520 | |a METHODS: Consecutive ALK-positive metastatic NSCLC patients treated with at least one ALKi were identified in the working databases of 7 Israeli oncology centers (the full cohort). Demographic and clinical data were collected. Patients receiving any systemic treatment beyond 2 ALKi comprised the third-line cohort, whether a third ALKi (group A) or chemotherapy (group B). Groups A and B were compared in terms of overall survival (OS) and time-to-next-treatment line (TNT) | ||
| 520 | |a RESULTS: At a median follow-up of 41 months (95% confidence interval [CI]: 32-55), 80 (47.1%) have died. Median OS (mOS) in the full cohort (n = 170) was 52 months (95% CI: 32-65). Number of ALKi (hazard ratio [HR] 0.765; 95% CI: 0.61-0.95; P = .024) and age (HR 1.02, 95% CI: 1.01-1.04, P = .009) significantly associated with OS in the full cohort. The third-line cohort included 40 patients, of which 27 were treated with third ALKi (group A) and 13 treated with chemotherapy (group B). mOS from third-line initiation was 27 months in group A (95% CI: 13-NR) and 13 months for group B (95% CI: 3-NR); the difference was not significant (NS; P = .12). Chemotherapy as first line (HR 0.17, 95% CI: 0.05-0.52, P = .002) and a higher number of ALKi (HR 0.38, 95% CI: 0.20-0.86, P = .011) associated significantly with longer OS of the third-line cohort. TNT was 10 months for group A (95% CI: 5-19) and 3 months for group B (95% CI: 0-NR); the difference was NS (P = .079) | ||
| 520 | |a CONCLUSION: We report mature real-world data of more than 4-year mOS in ALK-positive patients. The number of ALKi given was associated with a better outcome. OS and TNT demonstrated a statistically nonsignificant trend for a better outcome in patients receiving a third-line ALKi | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a ALK inhibitors | |
| 650 | 4 | |a ALK rearrangement | |
| 650 | 4 | |a non-small cell lung cancer | |
| 650 | 4 | |a targeted therapy | |
| 650 | 4 | |a third-line treatment | |
| 650 | 7 | |a Protein Kinase Inhibitors |2 NLM | |
| 650 | 7 | |a Trinitrotoluene |2 NLM | |
| 650 | 7 | |a 118-96-7 |2 NLM | |
| 650 | 7 | |a Anaplastic Lymphoma Kinase |2 NLM | |
| 650 | 7 | |a EC 2.7.10.1 |2 NLM | |
| 700 | 1 | |a Dudnik, Elizabeth |e verfasserin |4 aut | |
| 700 | 1 | |a Shamai, Sivan |e verfasserin |4 aut | |
| 700 | 1 | |a Rotenberg, Yakir |e verfasserin |4 aut | |
| 700 | 1 | |a Popovich-Hadari, Noa |e verfasserin |4 aut | |
| 700 | 1 | |a Wollner, Mira |e verfasserin |4 aut | |
| 700 | 1 | |a Zer, Alona |e verfasserin |4 aut | |
| 700 | 1 | |a Gottfried, Maya |e verfasserin |4 aut | |
| 700 | 1 | |a Mishaeli, Moshe |e verfasserin |4 aut | |
| 700 | 1 | |a Rosenberg, Shoshana Keren |e verfasserin |4 aut | |
| 700 | 1 | |a Onn, Amir |e verfasserin |4 aut | |
| 700 | 1 | |a Merimsky, Ofer |e verfasserin |4 aut | |
| 700 | 1 | |a Urban, Damien |e verfasserin |4 aut | |
| 700 | 1 | |a Peled, Nir |e verfasserin |4 aut | |
| 700 | 1 | |a Maimon, Natalie |e verfasserin |4 aut | |
| 700 | 1 | |a Bar, Jair |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The oncologist |d 1998 |g 27(2022), 1 vom: 03. Feb., Seite e76-e84 |w (DE-627)NLM095483306 |x 1549-490X |7 nnns |
| 773 | 1 | 8 | |g volume:27 |g year:2022 |g number:1 |g day:03 |g month:02 |g pages:e76-e84 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/oncolo/oyab005 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 27 |j 2022 |e 1 |b 03 |c 02 |h e76-e84 | ||