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Real-world outcomes according to treatment strategies in ALK-rearranged non-small-cell lung cancer (NSCLC) patients: an Italian retrospective study.

Abstract

PURPOSE

Anaplastic lymphoma kinase (ALK) rearrangement confers sensitivity to ALK inhibitors (ALKis) in non-small-cell lung cancer (NSCLC). Although several drugs provided an impressive outcome benefit, the most effective sequential strategy is still unknown. We describe outcomes of real-life patients according to the treatment strategy received.

PATIENTS

We retrospectively collected 290 ALK rearranged advanced NSCLC diagnosed between 2011 and 2017 in 23 Italian institutions.

RESULTS

After a median follow-up of 26 months, PFS for crizotinib and a new generation ALKis were 9.4 [CI 95% 7.9-11.2] and 11.1 months [CI 95% 9.2-13.8], respectively, while TTF were 10.2 [CI 95% 8.5-12.6] and 11.9 months [CI 95% 9.7-17.4], respectively, being consistent across the different settings. The composed outcomes (the sum of PFS or TTF) in patients treated with crizotinib followed by a new generation ALKis were 27.8 months [CI 95% 24.3-33.7] in PFS and 30.4 months [CI 95% 24.7-34.9] in TTF. The median OS from the diagnosis of advanced disease was 39 months [CI 95% 31.8-54.5]. Patients receiving crizotinib followed by a new generation ALKis showed a higher median OS [57 months (CI 95% 42.0-73.8)] compared to those that did not receive crizotinib [38 months (CI 95% 18.6-NR)] and those who performed only crizotinib as target agent [15 months (CI 95% 11.3-34.0)] (P < 0.0001).

CONCLUSION

The sequential administration of crizotinib and a new generation ALKis provided a remarkable clinical benefit in this real-life population, being an interesting option to consider in selected patients.

Authors+Show Affiliations

Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Regione Gonzole 10, 10043, Orbassano, Italy. elisa.gobbini@hotmail.it. Cancer Research Center Lyon, Centre Léon Bérard, 28 Rue Laennec, 69008, Lyon Cedex 08, France. elisa.gobbini@hotmail.it.Oncology Unit, Santa Maria della Misericordia Hospital, Sant'Andrea delle Fratte, 6156, Perugia, Italy.Medical Thoracic Unit, IRCCS Istituto Oncologico "Giovanni Paolo II", Viale Orazio Flacco 65, 70124, Bari, Italy.Medical Oncology Unit, University Hospital, Via Gramsci 14, 43123, Parma, Italy.Oncology Department, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, Italy.Oncology Unit, Department of Medicine, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy.UOSD Pneumologia Oncologica, San Camillo Forlanini Hospital, Circonvallazione Gianicolense 87, 00152, Roma, Italy.Oncology and Hematology Department, AUSL Romagna-Ravenna, Viale Randi 5, 48100, Ravenna, Italy.Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Roma, Italy.Oncology Unit, Antonio Cardarelli Hospital, Via Antonio Cardarelli 9, 80131, Napoli, Italy.Radiotherapy Unit, University Hospital Careggi, Largo Brambilla 3, 50134, Firenze, Italy.Medical Oncology Unit, San Giovanni Addolorata Hospital, Via dell'Amba Aradam 9, 00184, Rome, Italy.Oncology Unit, East Piedmont University, Maggiore della Carità Hospital, Corso Mazzini 18, 28100, Novara, Italy.Department of Oncology and Hematology, Foundation IRCCS 'Casa Sollievo della Sofferenza', Viale Cappuccini 1, 71013, San Giovanni Rotondo, Italy.Department of Oncology and Hematology, Foundation IRCCS 'Casa Sollievo della Sofferenza', Viale Cappuccini 1, 71013, San Giovanni Rotondo, Italy.Department of Oncology and Hematology, Foundation IRCCS 'Casa Sollievo della Sofferenza', Viale Cappuccini 1, 71013, San Giovanni Rotondo, Italy.Department of Medical Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, San Raffaele Hospital, Via Olgettina Milano 60, 20132, Milano, Italy.Oncology Unit, Valduce Hospital, Via Dante Alighieri 11, 22100, Como, Italy.Oncology Unit, A.O.R.N.A.S Garibaldi Nesima, Via Palermo 636, 95100, Catania, Italy.S.O.C. Oncologia Medica e dei Tumori Immunocorrelati, Centro di Riferimento Oncologico (CRO), IRCCS, Via Gallini 2, Aviano, Italy.Thoracic Oncology Group, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, IRCCS, Via Maroncelli 40, 47014, Meldola, Italy.Oncology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 28, 20122, Milan, Italy.Oncology Unit, ASST San Gerardo Hospital, Via G. B. Pergolesi 33, 20052, Monza, Italy.Medical Oncology Division and Breast Unit, Antonio Perrino Hospital, Strada Statale 7 per Mesagne, 72100, Brindisi, Italy.Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Regione Gonzole 10, 10043, Orbassano, Italy.Operative Unit of Pathologic Anatomy, Azienda Unità Sanitaria Locale della Romagna, Hospital St. Maria delle Croci, Viale Vincenzo Randi 5, 48121, Ravenna, Italy.U.O.C. Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Roma, Italy.Medical Thoracic Unit, IRCCS Istituto Oncologico "Giovanni Paolo II", Viale Orazio Flacco 65, 70124, Bari, Italy.Medical Oncology Unit, University Hospital, Via Gramsci 14, 43123, Parma, Italy.Department of Oncology, University of Turin, Mauriziano Umberto I, Via Magellano 1, 10128, Turin, Italy.Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Regione Gonzole 10, 10043, Orbassano, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31630357

Citation

Gobbini, E, et al. "Real-world Outcomes According to Treatment Strategies in ALK-rearranged Non-small-cell Lung Cancer (NSCLC) Patients: an Italian Retrospective Study." Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2019.
Gobbini E, Chiari R, Pizzutillo P, et al. Real-world outcomes according to treatment strategies in ALK-rearranged non-small-cell lung cancer (NSCLC) patients: an Italian retrospective study. Clin Transl Oncol. 2019.
Gobbini, E., Chiari, R., Pizzutillo, P., Bordi, P., Ghilardi, L., Pilotto, S., ... Novello, S. (2019). Real-world outcomes according to treatment strategies in ALK-rearranged non-small-cell lung cancer (NSCLC) patients: an Italian retrospective study. Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, doi:10.1007/s12094-019-02222-8.
Gobbini E, et al. Real-world Outcomes According to Treatment Strategies in ALK-rearranged Non-small-cell Lung Cancer (NSCLC) Patients: an Italian Retrospective Study. Clin Transl Oncol. 2019 Oct 19; PubMed PMID: 31630357.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Real-world outcomes according to treatment strategies in ALK-rearranged non-small-cell lung cancer (NSCLC) patients: an Italian retrospective study. AU - Gobbini,E, AU - Chiari,R, AU - Pizzutillo,P, AU - Bordi,P, AU - Ghilardi,L, AU - Pilotto,S, AU - Osman,G, AU - Cappuzzo,F, AU - Cecere,F, AU - Riccardi,F, AU - Scotti,V, AU - Martelli,O, AU - Borra,G, AU - Maiello,E, AU - Rossi,A, AU - Graziano,P, AU - Gregorc,V, AU - Casartelli,C, AU - Sergi,C, AU - Del Conte,A, AU - Delmonte,A, AU - Bareggi,C, AU - Cortinovis,D, AU - Rizzo,P, AU - Tabbò,F, AU - Rossi,G, AU - Bria,E, AU - Galetta,D, AU - Tiseo,M, AU - Di Maio,M, AU - Novello,S, Y1 - 2019/10/19/ PY - 2019/08/09/received PY - 2019/09/27/accepted PY - 2019/10/21/entrez PY - 2019/10/21/pubmed PY - 2019/10/21/medline KW - ALK inhibitors KW - Lung cancer KW - Sequence JF - Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico JO - Clin Transl Oncol N2 - PURPOSE: Anaplastic lymphoma kinase (ALK) rearrangement confers sensitivity to ALK inhibitors (ALKis) in non-small-cell lung cancer (NSCLC). Although several drugs provided an impressive outcome benefit, the most effective sequential strategy is still unknown. We describe outcomes of real-life patients according to the treatment strategy received. PATIENTS: We retrospectively collected 290 ALK rearranged advanced NSCLC diagnosed between 2011 and 2017 in 23 Italian institutions. RESULTS: After a median follow-up of 26 months, PFS for crizotinib and a new generation ALKis were 9.4 [CI 95% 7.9-11.2] and 11.1 months [CI 95% 9.2-13.8], respectively, while TTF were 10.2 [CI 95% 8.5-12.6] and 11.9 months [CI 95% 9.7-17.4], respectively, being consistent across the different settings. The composed outcomes (the sum of PFS or TTF) in patients treated with crizotinib followed by a new generation ALKis were 27.8 months [CI 95% 24.3-33.7] in PFS and 30.4 months [CI 95% 24.7-34.9] in TTF. The median OS from the diagnosis of advanced disease was 39 months [CI 95% 31.8-54.5]. Patients receiving crizotinib followed by a new generation ALKis showed a higher median OS [57 months (CI 95% 42.0-73.8)] compared to those that did not receive crizotinib [38 months (CI 95% 18.6-NR)] and those who performed only crizotinib as target agent [15 months (CI 95% 11.3-34.0)] (P < 0.0001). CONCLUSION: The sequential administration of crizotinib and a new generation ALKis provided a remarkable clinical benefit in this real-life population, being an interesting option to consider in selected patients. SN - 1699-3055 UR - https://www.unboundmedicine.com/medline/citation/31630357/Real-world_outcomes_according_to_treatment_strategies_in_ALK-rearranged_non-small-cell_lung_cancer_(NSCLC)_patients:_an_Italian_retrospective_study L2 - https://dx.doi.org/10.1007/s12094-019-02222-8 DB - PRIME DP - Unbound Medicine ER -