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Evaluation of clinicopathological features determining treatment response in patients with ALK mutant NSCLC
Izzet Dogan1, Mustafa Gurbuz2, Nail Paksoy1
1Istanbul University Institute of Oncology, Medical Oncology, Istanbul, Turkey.
Abstract:
ALK (anaplastic lymphoma kinase) inhibitors may be used to treat patients with ALK mutant metastatic nonsmall cell cancer (NSCLC). This study aimed to investigate the factors affecting the patients response to treatment with ALK-positive metastatic NSCLC. Data of the patients were investigated retrospectively. Binary regression analysis was performed to evaluate response predictors of treatment. Furthermore, we determined the cut-off value of the ALK-positivity for objective response to the therapy using ROC analysis. A total of 68 patients were included in the research. The median overall survival was observed 39.2 months. The overall response rate was 66.2%. The ratio of ALK positivity (P = .02), gender (P = .04), and the total number of metastatic sites (P = .02) all were detected as predictors of the response to ALK inhibitor in binary regression analysis. ALK inhibitor type (P = .56), primary tumor location (P = .35), pathological subtype (P = .68), de-novo metastatic disease (P = .28), and age (P = .94) were not predictive indicators for response. The cut-off level of ALK positivity was found to be 33% in patients with an objective response. The real-life effectiveness of ALK inhibitors in NSCLC patients with ALK mutations was shown in this research. We determined that having less than 3 metastatic sites, having a high ALK positivity ratio, and being female were all good predictors of ALK inhibitor response.
Insights
Anaplastic lymphoma kinase (ALK) inhibitors effectively treat ALK-mutant non-small cell lung cancer (NSCLC). High ALK positivity, female gender, and fewer metastatic sites predict better treatment response in NSCLC patients.
Area of Science:
- Oncology
- Pharmacology
- Genetics
Background:
- Anaplastic lymphoma kinase (ALK) inhibitors represent a targeted therapy for non-small cell lung cancer (NSCLC) harboring specific mutations.
- Understanding patient response predictors is crucial for optimizing ALK inhibitor treatment efficacy in metastatic NSCLC.
Purpose of the Study:
- To identify factors influencing patient response to ALK inhibitors in ALK-positive metastatic non-small cell lung cancer.
- To determine the optimal ALK-positivity threshold for predicting objective treatment response.
Main Methods:
- Retrospective analysis of 68 patients with ALK-mutant metastatic NSCLC treated with ALK inhibitors.
- Binary regression analysis to identify response predictors.
- Receiver Operating Characteristic (ROC) analysis to establish the ALK-positivity cut-off value.
Main Results:
- The overall response rate to ALK inhibitors was 66.2%, with a median overall survival of 39.2 months.
- Significant predictors of response included higher ALK positivity ratio (P=.02), female gender (P=.04), and fewer metastatic sites (P=.02).
- The optimal cut-off for ALK positivity predicting objective response was determined to be 33%.
Conclusions:
- Real-world data confirm the effectiveness of ALK inhibitors in NSCLC patients with ALK mutations.
- Favorable response to ALK inhibitors is associated with a high ALK positivity ratio, female sex, and limited metastatic burden (less than 3 sites).
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