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Sequential Use of Anaplastic Lymphoma Kinase Inhibitors in Japanese Patients With ALK-Rearranged Non-Small-Cell Lung Cancer: A Retrospective Analysis.
- Source :
-
Clinical lung cancer [Clin Lung Cancer] 2017 Jul; Vol. 18 (4), pp. e251-e258. Date of Electronic Publication: 2016 Dec 07. - Publication Year :
- 2017
-
Abstract
- Background: Second-generation anaplastic lymphoma kinase (ALK) inhibitors, such as alectinib and ceritinib, have recently been approved for treatment of ALK-rearranged non-small-cell lung cancer (NSCLC). An optimal strategy for using 2 or more ALK inhibitors has not been established. We sought to investigate the clinical impact of sequential use of ALK inhibitors on these tumors in clinical practice.<br />Patients and Methods: Patients with ALK-rearranged NSCLC treated from May 2010 to January 2016 at the National Cancer Center Hospital were identified, and their outcomes were evaluated retrospectively.<br />Results: Fifty-nine patients with ALK-rearranged NSCLC had been treated and 37 cases were assessable. Twenty-six received crizotinib, 21 received alectinib, and 13 (35.1%) received crizotinib followed by alectinib. Response rates and median progression-free survival (PFS) on crizotinib and alectinib (after crizotinib failure) were 53.8% (95% confidence interval [CI], 26.7%-80.9%) and 38.4% (95% CI, 12.0%-64.9%), and 10.7 (95% CI, 5.3-14.7) months and 16.6 (95% CI, 2.9-not calculable), respectively. The median PFS of patients on sequential therapy was 35.2 months (95% CI, 12.7 months-not calculable). The 5-year survival rate of ALK-rearranged patients who received 2 sequential ALK inhibitors from diagnosis was 77.8% (95% CI, 36.5%-94.0%).<br />Conclusion: The combined PFS and 5-year survival rates in patients who received sequential ALK inhibitors were encouraging. Making full use of multiple ALK inhibitors might be important to prolonging survival in patients with ALK-rearranged NSCLC.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Anaplastic Lymphoma Kinase
Carcinoma, Non-Small-Cell Lung genetics
Carcinoma, Non-Small-Cell Lung mortality
Crizotinib
Female
Follow-Up Studies
Humans
Japan
Lung Neoplasms genetics
Lung Neoplasms mortality
Male
Middle Aged
Neoplasm Staging
Receptor Protein-Tyrosine Kinases antagonists & inhibitors
Retrospective Studies
Survival Analysis
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Carbazoles therapeutic use
Carcinoma, Non-Small-Cell Lung drug therapy
Lung Neoplasms drug therapy
Oncogene Proteins, Fusion genetics
Piperidines therapeutic use
Pyrazoles therapeutic use
Pyridines therapeutic use
Receptor Protein-Tyrosine Kinases genetics
Subjects
Details
- Language :
- English
- ISSN :
- 1938-0690
- Volume :
- 18
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Clinical lung cancer
- Publication Type :
- Academic Journal
- Accession number :
- 28065466
- Full Text :
- https://doi.org/10.1016/j.cllc.2016.11.015