| ALK experts have long supported continuing patients on ALK TKI treatment while on chemotherapy based on clinical experience, but real-world evidence has been limited.. A group of familiar ALK key opinion leaders (KOLs) at 6 academic centers undertook a multicentered, retrospective study that included patients with ALK+ metastatic NSCLC who received platinum/pemetrexed (PT/Pem) alone, or with alectinib or lorlatinib (PT/Pem/TKI), after progression on next-generation ALK TKIs. 14% of patients were second-line, 45% third-line, 30% fourth-line BD 11% fifth-line or later Progression-free survival (PFS) was 6.6 months for patients receiving PT/Pem/TKI and 3.5 months for those receiving PT/Pem alone (HR, 0.75; P = .11). Median overall survival (OS) was 16.4 months versus 11.4 months (HR, 0.55; P = .041) respectively with no unanticipated toxicities. Among patients evaluable for intracranial outcomes, treatment with PT/Pem/TKI was associated with a significantly lower cumulative incidence of intracranial progression compared with PT/Pem alone (18.7% vs 34.0% at 12 months; HR, 0.33; P=.009>). These findings support the practice of continuing ALK TKI therapy during platinum/pemetrexed chemotherapy, particularly for patients at risk of intracranial progression, while highlighting the ongoing unmet need for more effective post-TKI treatment strategies. Read the research summary here: https://pubmed.ncbi.nlm.nih.gov/41671458/ |
Continuing ALK NSCLC TKI Treatment while on Chemotherapy Leads to Better Outcomes
A recent multi-center study examined outcomes for ALK-positive NSCLC patients who continued their ALK TKI while receiving platinum/pemetrexed chemotherapy after disease progression. The findings suggest that maintaining targeted therapy alongside chemotherapy may improve overall survival and reduce the risk of brain progression in certain patients.
