Real world experience of treatment and outcome in ALK-rearranged metastatic nonsmall cell lung cancer: A multicenter study from India

Background: Anaplastic lymphoma kinase (ALK) rearranged metastatic non-small cell lung cancer (NSCLC) comprises 5%-7% of all lung cancer and carries a good prognosis with available ALK-inhibitors. Majority of registration trials in ALK-inhibitors did not include Indian patients. Hence, this study was planned to analyze the outcome of Indian patients treated with ALK-inhibitors and associated challenges. Results: A total of 274 patients were studied, out of which 250 patients received ALK inhibitor and were analyzed further for outcome. The median age was 50 years (range: 24-82) and male to female ratio of 1.17:1. ALK was evaluated by immunohistochemistry in majority of patients (97%), 3 patients by FISH and 3 more patients were evaluated by both methods. Sixty-five percent (n = 162) of the patients received ALK-inhibitor as first line therapy, 51 patients received ALK-inhibitor as switch maintenance therapy after initial chemotherapy. Crizotinib and Ceritinib were used in 88% and 12%,..... READ ARTICLE

Cancer DOI:10.1016/j.currproblcancer.2020.100571.

Authors: Amol Patel, Ullas Batra, Kuruswamy Thurai Prasad, Deepak Dabkara, Joydeep Ghosh, Manasi Sharma, Navneet Singh, P. Suresh, Parveen Jain, Prabhat Singh Malik, Priyanshu Choudhary, Sandip Ganguly, Sachin Khurana, Shivashankara MS, Sneha Bothra, Valliappan Muthu, Bivas Biswas,

Pooled overall survival and safety data from the pivotal phase II studies (NP28673 and NP28761) of alectinib in ALK-positive non-small-cell lung cancer

Objectives: A pooled analysis of two open-label phase II studies of alectinib (NP28673 [NCT01801111] and NP28761 [NCT01871805]) demonstrated clinical activity in patients with advanced, anaplastic lymphoma kinase-positive (ALK+) non-small-cell lung cancer (NSCLC) previously treated with crizotinib. Longer-term and final pooled analyses of overall survival (OS) and safety data from the two studies are presented here. Conclusion: Updated results from this pooled analysis further demonstrate that alectinib has robust clinical activity and a manageable safety profile in patients with advanced, ALK+ NSCLC pretreated with crizotinib. READ ARTICLE

Lung Cancer DOI:10.1016/j.lungcan.2019.10.015

Authors: Sai-Hong Ignatius Ou, Shirish M. Gadgeel, Fabrice Barlesi, James Chih-Hsin Yang, Luigi De Petris, Dong-Wan Kim, Ramaswamy Govindan, Anne-Marie Dingemans, Lucio Crino, Hervé Léna, Sanjay Popat, Jin Seok Ahn, Eric Dansin, Emmanuel Mitry, Barbara Müller, Walter Bordogna, Bogdana Balas, Peter N. Morcos, Alice T. Shaw

Clinical TrialsKirk SmithOctober 14, 2019Alectinib, ALK+, NSCLC, Overall survival, Pooled analysis, Safety

Natural History and Factors Associated with Overall Survival in Stage IV ALK-Rearrange Non–Small Cell Lung Cancer

Clinical variables describing the natural history and longitudinal therapy outcomes of stage IV anaplastic lymphoma kinase gene rearrangement positive (ALK-positive) NSCLC and their relationship with long-term overall survival (OS) have not previously been described in detail.
Patients with stage IV NSCLC treated with an ALK inhibitor at the University of Colorado Cancer Center from 2009 through November 2017 were identified retrospectively. OS curves were constructed by using Kaplan-Meier methods. Multivariate Cox proportional hazard analysis was used to determine the relationship of variables with OS.
We concluded that patients with stage IV ALK-positive NSCLC can have prolonged OS. Brain metastases at diagnosis of stage IV disease does not influence OS. Having more organs involved with tumor at stage IV presentation is associated with worse outcomes. Prolonged benefit from pemetrexed is associated with better outcomes. READ ARTICLE

Journal of Thoracic Oncology DOI:10.1016/j.jtho.2018.12.014

Authors: Jose M. Pacheco, Dexiang Gao, Derek Smith, Thomas Purcell, Mark Hancock, Paul Bunn, Tyler Robin, Arthur Liu, Sana Karam, Laurie Gaspar, Brian Kavanagh, Chad Rusthoven, Dara Aisner, Robert Doebele, D. Ross Camidge