Outcomes of ALK positive lung cancer patients treated with crizotinib or second-generation ALK inhibitor: a monoinstitutional experience
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Elisa De Carlo1, Maria Chiara Del Savio1, Jerry Polesel2, Valentina Da Ros1, Eleonora Berto1, Sandra Santarossa1, Emanuela Chimienti1, Lucia Fratino1 and Alessandra Bearz1
1Medical Oncology Department, CRO-IRCCS, Aviano, Italy
2Epidemiology Unit, CRO-IRCCS, Aviano, Italy
Alessandra Bearz, email: [email protected]
Keywords: non-small cell lung cancer; anaplastic lymphoma kinase (ALK); ALK inhibitors; brain metastasis
Received: September 11, 2017 Accepted: February 21, 2018 Epub: February 26, 2018 Published: March 16, 2018
Rearrangement in the anaplastic lymphoma kinase (ALK) gene is one of the oncogenic drivers in non-small cell lung cancer (NSCLC) patients.
Several ALK inhibitors (ALKis) have been developed and have demonstrated their efficacy, however the best treatment strategy for ALK positive NSCLC patients has yet to be determined. Our retrospective study has investigated the outcome of 40 ALK-rearranged NSCLC patients treated with two different sequential strategies in our Institute; a “classical group”, treated with crizotinib followed by second or third generation ALKis, and the “experimental group”, treated upfront with a second generation ALK inhibitor. The primary endpoints investigated were Progression-free survival (PFS) and intracranial activity. The analysis has revealed a significant improvement in PFS (p = 0.050) in the experimental group, furthermore none of these patients developed brain metastasis. There was no statistically significant difference in OS, but all patients in the experimental group were still alive after a median follow up of 15 months. Our retrospective analysis suggests that systemic and intracranial efficacy tends to be better in the experimental group; randomized prospective studies could confirm our observations.
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