2022 World Conference on Lung Cancer (ePosters)-EP05.03-008. Surgery after First-Line Alectinib for (Locally) Advanced ALK-rearranged NSCLC: Pathological Response and Peri-Operative Results

EP05.03-008. Surgery after First-Line Alectinib for (Locally) Advanced ALK-rearranged NSCLC: Pathological Response and Peri-Operative Results

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This study aimed to investigate the role of surgery after first-line treatment with Alectinib in patients with locally advanced ALK-rearranged non-small cell lung cancer (NSCLC). The study involved nine patients who were treated with Alectinib and subsequently underwent lung resection. The primary endpoints of the study were the pathological response and surgical feasibility.<br /><br />The results showed that Alectinib was interrupted for an average of 7 days before surgery. None of the patients experienced grade 4 toxicity. All patients underwent a complete resection (R0 resection) during surgery. However, six cases (67%) encountered intra-operative difficulties. Three patients (33%) experienced minor post-operative complications, but there were no major complications.<br /><br />The pathological analysis revealed significant changes in the tumors. Five cases (55%) showed a pathological complete response (PCR), indicating a substantial reduction in tumor size and viable cells. Eight cases (89%) showed a major pathological response (MPR), which also indicated a significant reduction in tumor size and viable cells.<br /><br />The most common pathological changes observed were perivascular fibrosis, thickened tissues, and difficult mediastinal nodal dissection. These findings suggest that salvage surgery after Alectinib treatment is safe and feasible for locally advanced NSCLC. Moreover, an impressive pathological response can often be achieved.<br /><br />In conclusion, this study demonstrated that surgery after first-line Alectinib treatment is a viable option for patients with locally advanced ALK-rearranged NSCLC. The procedure was safe and effectively reduced the size of tumors. These findings contribute to the growing evidence supporting the use of targeted therapies and surgery in the treatment of advanced NSCLC.

Asset Subtitle

Filippo Lococo

Meta Tag

Speaker Filippo Lococo

Topic Locally Advanced Non-small Cell Lung Cancer - Surgery

Keywords

surgery

Alectinib

first-line treatment

locally advanced

ALK-rearranged

non-small cell lung cancer

NSCLC

pathological response

surgical feasibility

tumor reduction