1. The incidence of ALK inhibitor-related pneumonitis in advanced non-small-cell lung cancer patients: A systematic review and meta-analysis.
- Author
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Suh, Chong Hyun, Kim, Kyung Won, Pyo, Junhee, Hatabu, Hiroto, and Nishino, Mizuki
- Subjects
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NON-small-cell lung carcinoma , *PEMETREXED , *CRIZOTINIB , *PNEUMONIA , *ANAPLASTIC lymphoma kinase , *META-analysis , *CANCER patients - Abstract
• The overall incidence of ALK inhibitor pneumonitis was 2.14% in advanced NSCLC. • Patients from Japanese cohorts had a higher incidence of ALK-inhibitor pneumonitis. • Further studies of mechanisms and risk factors of ALK pneumonitis are needed. We evaluated the incidence of pneumonitis in clinical trials of anaplastic lymphoma kinase (ALK) inhibitors in patients with advanced non-small cell lung cancer (NSCLC) and compared the incidence among different cohorts, in order to identify possible predisposing factors for ALK inhibitor-related pneumonitis. MEDLINE and EMBASE search up to 1/30/18 using the keywords, "alectinib", "ceritinib", "crizotinib", "brigatinib", and "lung cancer", resulting in a total of 20 eligible cohorts with 2261 patients treated with ALK inhibitor monotherapy for advanced NSCLC. The pooled incidences of all-grade, high-grade, and grade 5 pneumonitis were calculated. Subgroup analyses were conducted with meta-regression using study-level covariates. The overall pooled incidence of pneumonitis was 2.14% (95% CI: 1.37–3.34) for all grade, 1.33% (95% CI: 0.80–2.21) for high grade, and 0.22% (95% CI: 0.09-0.52) for grade 5 pneumonitis. The incidence was significantly higher in studies from Japan compared to studies of non-Japan origin, for all-grade (6.25% vs 1.14%, p < 0.001) and high-grade pneumonitis (3.31% vs 0.39%, p < 0.001). Multivariate meta-regression demonstrated the cohorts from Japanese studies had significantly higher odds of pneumonitis for all-grade (odds ratio [OR]: 4.329 [95% CI: 1.918, 9.770], p < 0.001) compared to those of non-Japan origin, after adjusting for types of ALK inhibitors. The overall incidence of ALK inhibitor pneumonitis was 2.14% in patients with advanced NSCLS. The patients from Japanese cohorts had a higher incidence of ALK-inhibitor pneumonitis, which indicates the need for increased awareness and caution for pneumonitis in Japanese patients treated with ALK inhibitors. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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