Survival Analysis for Patients with ALK Rearrangement-Positive Non-Small Cell Lung Cancer and a Poor Performance Status Treated with Alectinib: Updated Results of Lung Oncology Group in Kyushu 1401.
Journal
The oncologist
ISSN: 1549-490X
Titre abrégé: Oncologist
Pays: England
ID NLM: 9607837
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
24
08
2019
accepted:
15
09
2019
entrez:
17
4
2020
pubmed:
17
4
2020
medline:
22
6
2021
Statut:
ppublish
Résumé
Alectinib confers a pronounced survival benefit in patients with ALK rearrangement-positive non-small cell lung cancer and a poor performance status. Survival benefit of alectinib for patients with a poor performance status was consistent regardless of the presence of central nervous system metastases. We previously reported a marked objective response rate (ORR) and safety for alectinib treatment in patients with ALK rearrangement-positive non-small cell lung cancer (NSCLC) and a poor performance status (PS) in the Lung Oncology Group in Kyushu (LOGiK) 1401 study. It remained unclear, however, whether alectinib might also confer a long-term survival benefit in such patients. Eighteen patients with ALK rearrangement-positive advanced NSCLC and a PS of 2, 3, or 4 (n = 12, 5, and 1, respectively) were enrolled in LOGiK1401 between September 2014 and December 2015 and received alectinib. We have now updated the survival data for the study. The median follow-up time for all patients was 27.3 months. The median progression-free survival (PFS) was 16.2 months (95% confidence interval [CI], 7.1-30.8 months), and the median survival time (MST) and the 3-year overall survival rate were 30.3 months (95% CI, 11.5 months to not reached) and 43.8% (95% CI, 20.8-64.7%), respectively. This survival benefit was similarly manifest in patients with a PS of 2 (MST, 20.5 months) and those with a PS of ≥3 (MST, not reached). PFS did not differ between patients with or without central nervous system (CNS) metastases at baseline (median of 17.5 and 16.2 months, respectively, p = .886). Alectinib showed a pronounced survival benefit for patients with ALK rearrangement-positive NSCLC and a poor PS regardless of the presence of CNS metastases, a patient population for which chemotherapy is not indicated.
Sections du résumé
LESSONS LEARNED
Alectinib confers a pronounced survival benefit in patients with ALK rearrangement-positive non-small cell lung cancer and a poor performance status. Survival benefit of alectinib for patients with a poor performance status was consistent regardless of the presence of central nervous system metastases.
BACKGROUND
We previously reported a marked objective response rate (ORR) and safety for alectinib treatment in patients with ALK rearrangement-positive non-small cell lung cancer (NSCLC) and a poor performance status (PS) in the Lung Oncology Group in Kyushu (LOGiK) 1401 study. It remained unclear, however, whether alectinib might also confer a long-term survival benefit in such patients.
METHODS
Eighteen patients with ALK rearrangement-positive advanced NSCLC and a PS of 2, 3, or 4 (n = 12, 5, and 1, respectively) were enrolled in LOGiK1401 between September 2014 and December 2015 and received alectinib. We have now updated the survival data for the study.
RESULTS
The median follow-up time for all patients was 27.3 months. The median progression-free survival (PFS) was 16.2 months (95% confidence interval [CI], 7.1-30.8 months), and the median survival time (MST) and the 3-year overall survival rate were 30.3 months (95% CI, 11.5 months to not reached) and 43.8% (95% CI, 20.8-64.7%), respectively. This survival benefit was similarly manifest in patients with a PS of 2 (MST, 20.5 months) and those with a PS of ≥3 (MST, not reached). PFS did not differ between patients with or without central nervous system (CNS) metastases at baseline (median of 17.5 and 16.2 months, respectively, p = .886).
CONCLUSION
Alectinib showed a pronounced survival benefit for patients with ALK rearrangement-positive NSCLC and a poor PS regardless of the presence of CNS metastases, a patient population for which chemotherapy is not indicated.
Identifiants
pubmed: 32297438
doi: 10.1634/theoncologist.2019-0728
pmc: PMC7160311
doi:
Substances chimiques
Carbazoles
0
Piperidines
0
Protein Kinase Inhibitors
0
Crizotinib
53AH36668S
Anaplastic Lymphoma Kinase
EC 2.7.10.1
alectinib
LIJ4CT1Z3Y
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
306-e618Informations de copyright
© AlphaMed Press; the data published online to support this summary are the property of the authors.
Références
J Clin Oncol. 2016 Mar 1;34(7):661-8
pubmed: 26598747
J Clin Oncol. 2009 Mar 20;27(9):1394-400
pubmed: 19224850
J Clin Oncol. 2013 Aug 10;31(23):2849-53
pubmed: 23775961
Lancet Respir Med. 2019 May;7(5):437-446
pubmed: 30981696
Lancet Oncol. 2016 Feb;17(2):234-242
pubmed: 26708155
N Engl J Med. 2017 Aug 31;377(9):829-838
pubmed: 28586279
Cancer Cell. 2011 May 17;19(5):679-90
pubmed: 21575866
Lancet. 2017 Jul 1;390(10089):29-39
pubmed: 28501140
Nature. 2007 Aug 2;448(7153):561-6
pubmed: 17625570
Lancet Oncol. 2013 Jun;14(7):590-8
pubmed: 23639470
Lancet Oncol. 2018 Dec;19(12):1654-1667
pubmed: 30413378
J Thorac Oncol. 2017 Jul;12(7):1161-1166
pubmed: 28238961
Lancet Oncol. 2012 Nov;13(11):1161-70
pubmed: 23078958
N Engl J Med. 2010 Oct 28;363(18):1693-703
pubmed: 20979469
J Med Chem. 2014 Jun 12;57(11):4720-44
pubmed: 24819116
Ann Oncol. 2014 Feb;25(2):415-22
pubmed: 24478318