Resumen de Real-world outcomes according to treatment strategies in ALK-rearranged non-small-cell lung cancer (NSCLC) patients: an Italian retrospective study
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 Conte, A. Delmonte, C. Bareggi, D. Cortinovis, P. Rizzo, F. Tabbò, G. Rossi, E. Bria, Domenico Galetta, M. Tiseo, Massimo Di Maio, S. Novello
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.
