Real-world anaplastic lymphoma kinase (ALK) rearrangement testing patterns, treatment sequences, and survival of ALK inhibitor-treated patients

Davies, Jessica; Martinec, Michael; Coudert, Mathieu; Delmar, Paul; Crane, Gracy

doi:10.1080/03007995.2018.1533458

Cited by 13 publications

(17 citation statements)

References 26 publications

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“…Similar to results from previously conducted studies of real-world treatment patterns for ALK+ NSCLC [25,26,[36][37][38][39], we found that crizotinib was the most commonly prescribed first-line ALK TKI therapy in clinical practice. In the second-line ALK TKI setting (post crizotinib), our results showed that ceritinib was the most commonly prescribed therapy, which is consistent with the approval timelines and similar to the results of other real-world studies [24,25,[37][38][39][40][41][42]. These results are not surprising, as crizotinib was initially approved by the FDA in 2011 and was the first commercially available ALK TKI therapy in the U.S. [43].…”

Section: Discussionsupporting

confidence: 87%

Real-World Treatment Patterns and Progression-Free Survival Associated with Anaplastic Lymphoma Kinase (ALK) Tyrosine Kinase Inhibitor Therapies for ALK+ Non-Small Cell Lung Cancer

et al. 2020

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Background. Little is known about real-world treatment and outcomes of patients with anaplastic lymphoma kinasepositive (ALK+) advanced non-small cell lung cancer (NSCLC). Patients and Methods. This retrospective study of the Flatiron Health EHR-derived deidentified database included patients with a lung cancer diagnosis and confirmed advanced NSCLC who received ALK tyrosine kinase inhibitor (TKI) therapy (January 1, 2011, through June 30, 2018). Patient characteristics and treatment patterns were characterized. Real-world progression-free survival (rwPFS) and time to discontinuation were calculated using the Kaplan-Meier method. Results. First-line ALK TKI therapy was administered to 581 patients (27.5% had brain metastasis on or prior to initiation) and second-line ALK TKI therapy to 254 patients post crizotinib (45.7% had brain metastasis on or prior to second-line ALK TKI initiation). Crizotinib (84.6%; n = 492) was the most commonly administered first-line ALK TKI therapy. For second-line ALK TKI post crizotinib (n = 254), 49.6% received ceritinib, 41.7% received alectinib, 5.9% received crizotinib retreatment, and 2.8% received brigatinib. Median (95% confidence interval [CI]) rwPFS was 7.47 (6.48-8.32) months for first-line and 7.30 (5.72-8.42) months for second-line ALK TKI. Median (95% CI) rwPFS was significantly longer among first-line ALK TKI patients without than with brain metastasis (8.52 [7.57-10.59] vs. 4.97 [3.75-5.99] months; p < .0001) and patients with brain metastasis on or prior to first-line ALK TKI therapy had a significantly increased risk of progression (hazard ratio AE SE, 1.976 AE 0.112; p < .0001). Conclusion. Median rwPFS in patients with advanced ALK+ NSCLC was < 8 months for firstand second-line ALK TKI therapy and was even shorter in patients with brain metastasis, highlighting the need for more effective treatments in this patient population. The Oncologist 2020;25:867-877 Implications for Practice: Results presented herein describe real-world treatment of advanced ALK+ NSCLC with ALK TKI therapies from January 2011 through June 2018. Crizotinib was the most commonly prescribed first-line ALK TKI therapy in this patient population, but the majority of data analyzed were obtained prior to Food and Drug Administration approval of alectinib and ceritinib in the first-line ALK TKI setting. Physicians should monitor patients closely to help identify when a change in treatment should occur.

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Section: Discussionsupporting

confidence: 87%

Real-World Treatment Patterns and Progression-Free Survival Associated with Anaplastic Lymphoma Kinase (ALK) Tyrosine Kinase Inhibitor Therapies for ALK+ Non-Small Cell Lung Cancer

et al. 2020

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“…An analysis from the Flatiron Health's database of over 200 predominantly community sites in the USA showed a median OS of only 29.4 months among 300 ALK+ NSCLC patients. The survival in the Flatiron Health database may have been lower than in the studies referenced above since patients were only treated with crizotinib or ceritinib (the significant majority only receiving crizotinib) and patients could not have been treated on a clinical trial [7].…”

Section: Long-term Survival For Stage IV Alk+ Nsclc: Access To Next-gmentioning

confidence: 96%

“…Specifically, in their dataset, the median OS was 27.1 months (95% CI 22.0-35.0) in ALK+ patients with CNS metastases, versus 36.9 months (95% CI 25.1-not reached) among those without. However, patients in the Flatiron Health analysis did not receive highly CNS penetrant next-generation ALK inhibitors and information was lacking on the utilization of locally ablative therapies [7].…”

Section: Impact Of Brain Metastasismentioning

confidence: 99%

Is long-term survival possible for patients with stage IV ALK+ non-small cell lung cancer?

Pacheco

Camidge

2019

Expert Review of Respiratory Medicine

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“…Screening of titles and abstracts allowed the selection of 131 potentially eligible studies. Among them, a total of 32 studies fulfilled the eligibility criteria and were finally included into the review [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. No further studies were retrieved through a snowballing search.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-six out of 32 included studies used rcEHD from North America [ 27 , 28 , 29 , 30 , 31 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ], two studies used data from Asia [ 24 , 32 ], three from Europe [ 26 , 42 , 55 ], and one from Australia [ 25 ]. Thirteen studies used record linkage of ≥1 type of data source [ 24 , 25 , 26 , 28 , 30 , 32 , 35 , 36 , 42 , 44 , 45 , 50 , 55 ], while 19 studies were based on one data source type only.…”

Section: Resultsmentioning

confidence: 99%

Real-World Utilization of Target- and Immunotherapies for Lung Cancer: A Scoping Review of Studies Based on Routinely Collected Electronic Healthcare Data

Spini

Hyeraci

Bartolini

et al. 2021

IJERPH

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Routinely collected electronic healthcare data (rcEHD) have a tremendous potential for enriching pre-marketing evidence on target- and immunotherapies used to treat lung cancer (LC). A scoping review was performed to provide a structured overview of available rcEHD-based studies on this topic and to support the execution of future research by facilitating access to pertinent literature both for study design and benchmarking. Eligible studies published between 2016 and 2020 in PubMed and ISI Web of Science were searched. Data source and study characteristics, as well as evidence on drug utilization and survival were extracted. Thirty-two studies were included. Twenty-six studies used North American data, while three used European data only. Thirteen studies linked ≥1 data source types among administrative/claims data, cancer registries and medical/health records. Twenty-nine studies retrieved cancer-related information from medical records/cancer registries and 31 studies retrieved information on drug utilization or survival from medical records or administrative/claim data. Most part of studies concerned non-small-cell-LC patients (29 out of 32) while none focused on small-cell-LC. Study cohorts ranged between 85 to 81,983 patients. Only two studies described first-line utilization of immunotherapies. Results from this review will serve as a starting point for the execution of future rcEHD-based studies on innovative LC pharmacotherapies.

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Real-world anaplastic lymphoma kinase (ALK) rearrangement testing patterns, treatment sequences, and survival of ALK inhibitor-treated patients

Cited by 13 publications

References 26 publications

Real-World Treatment Patterns and Progression-Free Survival Associated with Anaplastic Lymphoma Kinase (ALK) Tyrosine Kinase Inhibitor Therapies for ALK+ Non-Small Cell Lung Cancer

Real-World Treatment Patterns and Progression-Free Survival Associated with Anaplastic Lymphoma Kinase (ALK) Tyrosine Kinase Inhibitor Therapies for ALK+ Non-Small Cell Lung Cancer

Is long-term survival possible for patients with stage IV ALK+ non-small cell lung cancer?

Real-World Utilization of Target- and Immunotherapies for Lung Cancer: A Scoping Review of Studies Based on Routinely Collected Electronic Healthcare Data

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