Effect of central nervous system (CNS) metastases in a real-world multicenter cohort study of Spanish ALK-positive non-small cell lung cancer (NSCLC) patients (p)

Abstract

Of 335 ALKþ NSCLC patients with follow-up between Jan 2015ÀSep 2017, 32 (9.5%) patients were treated with IO therapy. Median age was 62.5 years, with 78.1% of patients diagnosed at stage IV, and 24 patients receiving nivolumab. Of the 32 IO treated patients, 15.6% received IO therapy before first ALK TKI, and 59.4% were treated with IO therapy after !2 ALK TKIs. Median (95% CI) time to discontinuation of IO therapy was 1.88 months (0.95 À 2.80), rwPFS was 2.17 months (1.18 À 2.93), and OS was 6.71 months (2.80ÀNE). Conclusions: We identified ALKþNSCLC patients who received IO therapy; most of whom were treated post ALK TKI. Time to discontinuation of IO therapy was short, and real-world effectiveness (rwPFS and OS) was limited. These results point to IO therapy's relative futility in ALKþ NSCLC patients. Compared to IO therapy, several approved ALK inhibitors have shown better effectiveness in both first and later lines of therapy. However, the optimal sequencing of ALK inhibitors with other therapies, including chemotherapy and IO therapy, remains unclear.