A real‑world study of treatment patterns and survival outcome in advanced anaplastic lymphoma kinase‑positive non‑small‑cell lung cancer

Abstract

Abstract.Crizotinib is an anti-cancer drug with a substantial beneficial effect in advanced non-small-cell lung cancer (NSCLC) patients harboring anaplastic lymphoma kinase (ALK) rearrangement. However, the real-world data currently available on this drug are limited. Thus, the present study aimed to retrospectively examine the treatment patterns and survival outcome of 83 advanced NSCLC patients with ALK rearrangement in a single center in China. Of the 83 patients enrolled, 33 (39.8%) patients received crizotinib and the remaining 50 (60.2%) patients received chemotherapy as the initial therapy. The first-line use of crizotinib prolonged the PFS1 (progression-free survival to the first detection of subsequent disease progression) compared with chemotherapy (median, 18.5 vs. 4.9 months; P<0.001), however, it did not prolong the overall survival (OS; P= 0.802). At the last follow up, 71 (85.5%) patients had received crizotinib and 12 (14.5%) patients were crizotinib-naive. Patients who had received crizotinib exhibited a significantly longer OS as compared with those who were crizotinib-naive [hazard ratio (HR) for mortality, 0.279; 95% confidence interval, 0.107-0.727; P<0.05). Among the 71 patients who had received crizotinib, this was administered as a first-line therapy in 33 (46.5%) cases, as a second-line therapy in 22 (31.0%) cases and after the second-line therapy in 16 (22.5%) cases. No significant difference in the OS among the three groups was observed (P=0.577). The Cox multivariate analysis identified the following independent negative prognostic factors for OS: Smoking history (HR=4.565), liver invasion at diagnosis (HR=4.294) and bone invasion at diagnosis (HR=2.587). In addition, the use of crizotinib (HR= 0.319) was identified as a positive prognostic factor for OS. In conclusion, the present real-world study revealed that the use of crizotinib improved the long-term survival of patients with ALK-positive advanced NSCLC. There was no difference in survival outcome between patients with initial use of crizotinib and those with subsequent use of crizotinib after first-line therapy.

Identification of Three lncRNAs as Potential Predictive Biomarkers of Lung Adenocarcinoma

“…e molecular biomarkers may improve the early lung cancer detection [4]. Furthermore, traditional chemotherapy that is based on histopathology is replaced by the individualized precision treatment which is based on carcinogenic factors [5].…”

Identification of Candidate Biomarkers Correlated With the Pathogenesis and Prognosis of Non-small Cell Lung Cancer via Integrated Bioinformatics Analysis

“…Over the past decades, our understanding of the molecular characterization of cancer has increased though genomic medicine. The treatment strategy for advanced NSCLC has changed from the traditional chemotherapy based on histopathology to individualized precision treatment based on carcinogenic factors ( Jin et al, 2018 ). Zhu et al indicated that MTA1 might be a momentous biomarker in the diagnosis of NSCLC.…”

Serum CEA and CYFRA Levels in ALK-rearranged NSCLC Patients: Correlation With Distant Metastasis

“…This was the first study to include more than 100 ALK-rearranged NSCLC patients. Regarding prognostic factors, several researchers are conducting studies in ALKrearranged NSCLC patients (7,(25)(26)(27). Among them, there was an interesting report from the research group of Jin et al (7).…”

“…Regarding prognostic factors, several researchers are conducting studies in ALKrearranged NSCLC patients (7,(25)(26)(27). Among them, there was an interesting report from the research group of Jin et al (7). According to their report, liver and bone invasions were significant unfavorable prognostic factors in ALKrearranged NSCLC patients (7).…”

“…Because of the rarity of ALK-rearranged NSCLC, it is important to collect and evaluate data in clinical practice in addition to results from clinical trials. Recently, an interesting study pointed out that liver and bone invasion were unfavorable prognostic factors in patients with ALK-rearranged gene mutations (7).…”