Related Experiment Video
Updated: Aug 14, 2025
Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
Clinical Profile, Practice Pattern, and Outcomes With First-Line Therapy in ALK-Positive Lung Cancer: Real-World Data
Akhil Kapoor1, Vanita Noronha2, Vijay Patil2
1Department of Medical Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Center and Homi Bhabha Cancer Hospital (A Unit of Tata Memorial Centre, Mumbai), Varanasi, India.
Introduction:
ALK inhibitors are one of the success stories in precision medicine for treating patients with advanced ALK-positive NSCLC. Nevertheless, developing countries have substantial constraints in using ALK inhibitors, with limited data from India.
Methods:
An audit of a prospectively collected database of patients with advanced ALK-positive NSCLC treated from January 2013 to March 2018 was conducted. The SPSS version 20.0 was used for statistical analysis.
Results:
A total of 441 patients were available for analysis; 62.5% were males, median age was 50 (range: 19-75) years, and 78.3% had Eastern Cooperative Oncology Group performance status of 0 to 1. When all the lines of therapies were included in the analysis, ALK inhibitors could be used in 379 (85.9%) of the total ALK-positive patients and 292 patients (66.2%) received ALK inhibitors in the first line in any strategy. The major reason for not starting ALK inhibitors upfront was financial constraints in 69% of the patients. The median progression-free survival on first-line therapy for the entire cohort was 14.1 months (95% confidence interval [CI]: 12.2-15.9), with a significant difference between patients receiving ALK inhibitor in first line in any strategy versus not in first line (17.2 mo [95% CI: 14.5-19.9] versus 5.9 mo [95% CI: 4.2-7.6], p < 0.001). The median overall survival was 30.7 months (95% CI: 27.3-34.2), with 37.6 months (95% CI: 28.1-47.1) for ALK inhibitor in the first line versus 20.5 months (95% CI: 15.8-25.1) for subsequent lines of therapy (p < 0.001).
Conclusions:
Most of our patients with ALK-positive NSCLC were exposed to ALK inhibitors through various support mechanisms. Those patients who could receive ALK inhibitors in the first line had a significant survival advantage as compared with others.
Insights
ALK inhibitors improve outcomes for advanced ALK-positive NSCLC patients. Early use in India significantly boosts survival, despite financial barriers, highlighting the need for access.
Area of Science:
- Oncology
- Precision Medicine
- Pharmacoeconomics
Background:
- Anaplastic Lymphoma Kinase (ALK) inhibitors represent a significant advancement in treating advanced ALK-positive Non-Small Cell Lung Cancer (NSCLC).
- Developing nations face challenges in accessing and utilizing ALK inhibitors, with limited data available from India.
- Understanding treatment patterns and outcomes in India is crucial for improving patient access and care.
Purpose of the Study:
- To audit the utilization and outcomes of ALK inhibitors in Indian patients with advanced ALK-positive NSCLC.
- To evaluate the impact of first-line ALK inhibitor therapy on patient survival.
- To identify barriers to ALK inhibitor use in this population.
Main Methods:
- A prospective database of 441 advanced ALK-positive NSCLC patients treated between January 2013 and March 2018 was audited.
- Statistical analysis was performed using SPSS version 20.0.
- Outcomes, including progression-free survival (PFS) and overall survival (OS), were compared based on first-line treatment strategy.
Main Results:
- ALK inhibitors were used in 85.9% of patients, with 66.2% receiving them as first-line therapy.
- Financial constraints were the primary reason for not initiating ALK inhibitors upfront (69%).
- First-line ALK inhibitor therapy significantly improved median PFS (17.2 months vs. 5.9 months) and OS (37.6 months vs. 20.5 months) compared to later use (p < 0.001).
Conclusions:
- Most patients in India accessed ALK inhibitors through support mechanisms.
- Initiating ALK inhibitors as first-line therapy confers a substantial survival advantage in advanced ALK-positive NSCLC.
- Addressing financial barriers is critical to optimize ALK inhibitor utilization and improve patient outcomes in India.
More Related Videos
04:04Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
Published on: February 12, 2017
07:42Patient-Derived Tumor Explants As a "Live" Preclinical Platform for Predicting Drug Resistance in Patients
Published on: February 7, 2021
Related Concept Videos
02:57Targeted Cancer Therapies
There are several types of targeted therapies against...
02:56Treatment Resistant Cancers
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
01:21Cancer Survival Analysis
02:50Combination Therapies and Personalized Medicine
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...