Real Clinical Practice in ALK-rearranged NSCLC Patients: A Retrospective Observational Study
Shinichiro Okauchi1, Takeshi Numata2, Takeshi Nawa3
1Division of Respiratory Medicine, Mito Kyodo General Hospital-Mito Medical Center, University of Tsukuba, Mito, Japan.
Background/Aim:
To describe real clinical outcomes when using systemic therapy to treat non-small cell lung cancer (NSCLC) patients who have anaplastic lymphoma kinase (ALK) fusion gene mutation.
Patients And Methods:
We performed a retrospective chart review from April 2008 to March 2019 sourced from 16 medical institutes that cover a population of three million people.
Results:
There were 129 ALK rearranged NSCLC patients. Among them, 103 patients including 40 recurrent disease cases received ALK-tyrosine kinase inhibitors (TKI) and chemotherapy. Our treatment results were comparable to previously reported clinical trials and clinical practice studies. First-line alectinib, treatment sequence of ALK-TKI followed by another ALK-TKI, and pemetrexed-containing chemotherapy contributed to the outcome of treatment.
Conclusion:
By arrangement of treatment such as treatment sequence of ALK-TKI and chemotherapy regimen, it might be possible to obtain a treatment outcome almost equivalent to those of clinical trials even in real clinical practice.
Insights
Systemic therapy for non-small cell lung cancer (NSCLC) with anaplastic lymphoma kinase (ALK) gene mutations shows real-world outcomes comparable to clinical trials. Strategic sequencing of ALK-tyrosine kinase inhibitors (TKIs) and chemotherapy improves treatment effectiveness.
Area of Science:
- Oncology
- Genetics
- Pharmacology
Background:
- Non-small cell lung cancer (NSCLC) patients with anaplastic lymphoma kinase (ALK) gene mutations require effective systemic therapies.
- Real-world clinical outcomes for ALK-mutated NSCLC are crucial for treatment optimization.
Purpose of the Study:
- To describe real-world clinical outcomes of systemic therapy in non-small cell lung cancer (NSCLC) patients harboring anaplastic lymphoma kinase (ALK) fusion gene mutations.
- To evaluate the impact of treatment sequencing and regimen choice on patient outcomes.
Main Methods:
- Retrospective chart review of 129 ALK-rearranged NSCLC patients from April 2008 to March 2019.
- Data sourced from 16 medical institutes covering three million people.
- Analysis of treatment sequences including ALK-tyrosine kinase inhibitors (TKIs) and chemotherapy.
Main Results:
- 103 patients received ALK-TKIs and chemotherapy, with 40 cases of recurrent disease.
- Treatment outcomes were comparable to previously reported clinical trials and studies.
- First-line alectinib, sequential ALK-TKI therapy, and pemetrexed-containing chemotherapy were associated with positive outcomes.
Conclusions:
- Optimizing treatment sequences of ALK-TKIs and chemotherapy regimens can achieve outcomes similar to clinical trials in real-world practice.
- Strategic therapeutic arrangements are key to managing ALK-mutated NSCLC effectively.
- Real-world data supports the efficacy of specific TKI and chemotherapy combinations.
