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Pattern of care and survival of anaplastic lymphoma kinase rearranged non-small cell lung cancer (ALK+ NSCLC) in an Australian Metropolitan Tertiary Referral Centre: A retrospective cohort analysis.
- Source :
-
Asia-Pacific journal of clinical oncology [Asia Pac J Clin Oncol] 2018 Oct; Vol. 14 (5), pp. e275-e282. Date of Electronic Publication: 2018 Apr 19. - Publication Year :
- 2018
-
Abstract
- Aim: To report on the pattern of care and survival of anaplastic lymphoma kinase rearranged non-small cell lung cancer (ALK+NSCLC) in a real-world retrospective cohort from an Australian tertiary referral center.<br />Methods: Individuals with a pathological diagnosis of ALK+NSCLC via immunohistochemistry and fluorescence in situ hybridization and a radiological diagnosis of stage IV disease were eligible. Patients were identified via the Pathology Department specimen database and electronic patient chart review. Data were collected and analyzed for baseline demographics, radiological pattern of disease and response to treatment, treatment sequencing, toxicity and survival.<br />Results: Thirty-five patients were identified over a 7-year period from 2010 to 2016 and followed for a median of 23 months. Median overall survival (OS) in the entire cohort was immature at data cut, 46.0 months (95% confidence interval [CI], 22.53-69.47 months), with the longest surviving patient was alive 62.1 months since diagnosis. Objective radiological response rate overall across six potential treatments and six treatment lines (range 1-6) was 58.2%. Almost 50% received at-least two lines of ALK inhibitor therapy with median OS in this group estimated to be 53.4 months (95% CI, 35.1 months-not reached). Toxicity was manageable with a low rate of ≥ grade 3 toxicity (n = 7). Forty-eight percent relapsed within the CNS and 43% overall died due to CNS progression. In those with CNS diagnosis at baseline and/or progression within the CNS (n = 32), median OS was also 46.0 months (95% CI, 24.22-66.78 months).<br />Conclusion: This retrospective cohort analysis of a single tertiary institution experience in treating ALK+NSCLC demonstrates impressive OS and the importance and impact of careful management of CNS disease in this patient population.<br /> (© 2018 John Wiley & Sons Australia, Ltd.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Antineoplastic Agents therapeutic use
Australia
Carcinoma, Non-Small-Cell Lung genetics
Cohort Studies
Disease Progression
Female
Humans
In Situ Hybridization, Fluorescence
Lung Neoplasms genetics
Male
Middle Aged
Protein Kinase Inhibitors therapeutic use
Radiotherapy mortality
Retrospective Studies
Tertiary Care Centers statistics & numerical data
Anaplastic Lymphoma Kinase genetics
Carcinoma, Non-Small-Cell Lung mortality
Carcinoma, Non-Small-Cell Lung therapy
Lung Neoplasms mortality
Lung Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1743-7563
- Volume :
- 14
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Asia-Pacific journal of clinical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 29675948
- Full Text :
- https://doi.org/10.1111/ajco.12877