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

• E. Gobbini ^[1] ; R. Chiari ^[10] ; P. Pizzutillo ^[11] ; P. Bordi ^[12] ; L. Ghilardi ^[2] ; S. Pilotto ^[3] ; G. Osman ^[13] ; F. Cappuzzo ^[14] ; F. Cecere ^[15] ; F. Riccardi ^[4] ; V. Scotti ^[16] ; O. Martelli ^[17] ; G. Borra ^[5] ; E. Maiello ^[18] ; A. Rossi ^[18] ; P. Graziano ^[18] ; V. Gregorc ^[19] ; C. Casartelli ^[6] ; C. Sergi ^[20] ; A. Del Conte ^[21] ; A. Delmonte ^[7] ; C. Bareggi ^[8] ; D. Cortinovis ^[22] ; P. Rizzo ^[23] ; F. Tabbò ^[1] ; G. Rossi ^[24] ; E. Bria ^[9] ; D. Galetta ^[25] ; M. Tiseo ^[12] ; M. Di Maio ^[1] ; S. Novello ^[1]
  1. [1] University of Turin

     University of Turin

     Torino, Italia

     
  2. [2] Ospedale Papa Giovanni XXIII

     Ospedale Papa Giovanni XXIII

     Bérgamo, Italia

     
  3. [3] University of Verona

     University of Verona

     Verona, Italia

     
  4. [4] Ospedale Antonio Cardarelli

     Ospedale Antonio Cardarelli

     Nápoles, Italia

     
  5. [5] University of Eastern Piedmont Amadeo Avogadro

     University of Eastern Piedmont Amadeo Avogadro

     Vercelli, Italia

     
  6. [6] Ospedale Valduce

     Ospedale Valduce

     Como, Italia

     
  7. [7] Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori

     Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori

     Meldola, Italia

     
  8. [8] Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

     Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

     Milán, Italia

     
  9. [9] Catholic University of the Sacred Heart

     Catholic University of the Sacred Heart

     Milán, Italia

     
  10. [10] Ospedale Santa Maria della Misericordia, Italia
  11. [11] IRCCS Istituto Oncologico “Giovanni Paolo II”, Italia
  12. [12] Azienda Ospedaliero-Universitaria di Parma, Italia
  13. [13] Azienda Ospedaliera San Camillo Forlanini, Italia
  14. [14] Azienda Unità Sanitaria Locale della Romagna-Ravenna, Italia
  15. [15] Istituto Nazionale Tumori Regina Elena, Italia
  16. [16] Azienda Ospedaliero-Universitaria Careggi, Italia
  17. [17] Azienda Ospedaliera San Giovanni Addolorata, Italia
  18. [18] Ospedale Casa Sollievo della Sofferenza, Italia
  19. [19] Istituto di Ricovero e Cura a Carattere Scientifico, IRCCS Ospedale San Raffaele, Italia
  20. [20] A.O.R.N.A.S Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Garibaldi, Italia
  21. [21] Centro di Riferimento Oncologico (CRO), IRCCS, Italia
  22. [22] Ospedale San Gerardo, Italia
  23. [23] Ospedale Antonio Perrino, Italia
  24. [24] Azienda Unità Sanitaria Locale della Romagna, Ospedale St. Maria delle Croci, Italia
  25. [25] Istituto Tumori Bari Giovanni Paolo II, Italia

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 22, Nº. 3 (March), 2020, págs. 294-301
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • 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.