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Variables Influencing Overall Survival in <em>ALK</em>-Positive NSCLC

By: Kayci Reyer
Posted: Tuesday, January 15, 2019

Patients with stage IV anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC) may experience prolonged overall survival, with a median overall survival of nearly 7 years, according to research published in the Journal of Thoracic Oncology. Jose M. Pacheco, MD, of the University of Colorado Cancer Center, and colleagues investigated the association between the natural history and treatment outcomes of patients and their long-term survival. They found that brain metastases at diagnosis in these patients did not seem to significantly influence overall survival.

“What this shows is that with the development of good targeted therapies for ALK-positive lung cancer, even patients with stage IV disease can do well for many, many years,” commented Dr. Pacheco in an institutional press release.

A total of 110 patients with stage IV ALK-positive NSCLC were retrospectively identified for this study, with 105 receiving initial inhibitor with the ALK inhibitor crizotinib. Among patients who experienced disease progression after crizotinib therapy, 78% were assigned to receive a different ALK inhibitor. At a median follow-up of 47 months, the median overall survival from stage IV diagnosis was 81 months (6.8 years).

For patients undergoing pemetrexed-based chemotherapy, the investigators noted a 7% decrease in the relative risk of death for each month on therapy. However, an association was found between the number of organs with tumor at the time of stage IV diagnosis and worsened overall survival (hazard ratio = 1.49 per organ with disease including the central nervous system, P = .002). Researchers found no association between brain metastasis at stage IV diagnosis (hazard ratio = 1.01, P = .971) or year of stage IV diagnosis (P = .887) and overall survival.

Disclosure: The study authors’ disclosure information can be found at sciencedirect.com.



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