Survival outcomes of alectinib in postoperative recurrent ALK-rearranged lung cancer

The clinical benefits of anaplastic lymphoma kinase (ALK) inhibitors in patients with recurrent ALK-rearranged lung adenocarcinoma after surgical resection remain poorly understood. We retrospectively reviewed the medical records of 10 patients who received alectinib as first-line therapy for postoperative recurrence between 2014 and 2018, following complete resection at multiple institutions in Japan. Clinical outcomes, including the progression-free survival (PFS) and overall survival (OS), were analyzed. The median follow-up duration was 93.6 months from surgery. The median OS was 96.8 months after surgery and 82.8 months from recurrence. The median PFS from recurrence was not reached, with a 5-year PFS rate of 58.3%. One patient discontinued treatment because of adverse events. Alectinib, as a first-line therapy for recurrent ALK-rearranged lung adenocarcinoma, demonstrated durable efficacy and acceptable safety. These findings suggest that targeted therapy for recurrence is a valuable treatment strategy. Prospective studies are warranted to determine the optimal timing for ALK-TKI initiation.