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WCLC 2019: Real-World Data on Sequential Therapy for ALK-Positive Lung Cancer

By: Susan Reckling
Posted: Tuesday, September 10, 2019

According to a review of clinical data on more than 800 patients with ALK-positive non–small cell lung cancer (NSCLC), those treated with crizotinib had a significantly longer time to treatment failure than those treated with alectinib. However, sequential therapy with crizotinib followed by alectinib did not reveal an overall survival benefit. Satomi Watanabe, MD, PhD, of Kindai University Faculty of Medicine, Osaka, Japan, and colleagues presented their findings at the International Association for the Study of Lung Cancer 2019 World Conference on Lung Cancer (WCLC) in Barcelona (Abstract OA02.06).

The investigators evaluated the clinical data on 840 patients with ALK-rearranged NSCLC who received crizotinib or alectinib between May 2012 and December 2016. These patients, 95% of whom had adenocarcinomas, were grouped according to the first ALK inhibitor received. A total of 535 patients had received crizotinib first (crizotinib group), and 305 had received alectinib first (alectinib group); of those who received crizotinib first, 282 received alectinib after crizotinib failure.

The combined time to treatment failure with the sequential strategy of crizotinib followed by alectinib was found to be significantly longer in the crizotinib group than in the alectinib group (median of 34.4 vs. 27.2 months; hazard ratio = 0.709; P = .0044). However, no significant difference in overall survival was noted between those who received alectinib after crizotinib in the crizotinib group and those in the alectinib group (median of 88.4 months vs. not reached; hazard ratio = 1.048; P = .7770). Finally, in the entire study population, a significantly shorter overall survival was reported in the crizotinib group than in the alectinib group (median of 53.6 months vs. not reached; hazard ratio = 1.821; P < .0001).

Disclosure: The study authors’ disclosure information may be found at wclc2019.iaslc.org.



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