Analysis of Serious Weight Gain in Patients Using Alectinib for ALK-Positive Lung Cancer

Leeuw, Simon P. de; Pruis, Melinda A.; Sikkema, Barend J.; Mohseni, Mostafa; Veerman, G.; Paats, Marthe S.; Dumoulin, Daphne W; Smit, Egbert F.; Schols, A.M.W.J.; Mathijssen, Ron H.J.; Rossum, Elisabeth F.C. van; Dingemans, Anne‐Marie C.

doi:10.1016/j.jtho.2023.03.020

Cited by 7 publications

(1 citation statement)

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“…Recently, a prospective trial analyzed the influence of Alectinib on body change composition; they demonstrated that Alectinib can cause a significant increase in sarcopenic abdominal obesity soon after initiation. This can lead to many serious metabolic, physical, and mental disturbances in long-term survivors [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Efficacy of ALK Inhibitors According to Body Mass Index in ALK Rearranged NSCLC Patients—A Retrospective Observational Study

Siringo

Gentile

Caponnetto

et al. 2023

Cancers

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No evidence exists as to whether body mass index (BMI) impairs clinical outcomes from ALK inhibitors (ALKi) in patients with ALK-rearranged non-small cell lung cancer (NSCLC). Retrospective data of patients affected by metastatic ALK-rearranged NSCLC treated with ALKi were collected. We divided patients into “low- BMI” (≤25 kg/m2) and “high- BMI” (>25 kg/m2) categories and correlated them with overall survival (OS) and progression-free survival (PFS). We included 40 patients treated with ALKi. We observed a 3-year OS of 81.5% in high-BMI vs. 49.6% in low-BMI categories (p = 0.049); the 3-year first-line PFS was superior in high-BMI vs. low-BMI patients (47% vs. 19%, p = 0.019). As expected, patients treated with Alectinib had a 55.6% 3-year PFS vs. 7.1% for others treated with ALKi (p = 0.025). High-BMI was associated with a 100% 3-year PFS rate vs. 25.4% in low-BMI Alectinib patients (p = 0.03). BMI was independently correlated with first-line PFS and OS at multivariate analysis with PS (HR 0.39, CI 95% 0.16–0.96, p = 0.042; HR 0.18, CI 95% 0.05–0.61, p = 0.006). High-BMI was associated with higher efficacy in ALK-rearranged patients. These results are particularly exciting for Alectinib and could be correlated to mechanisms that should be investigated in subsequent prospective studies.

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Section: Discussionmentioning

confidence: 99%