2023 World Conference on Lung Cancer (Posters)-EP12.02. Sequencing Patterns and Treatment Effectiveness in ALK-positive aNSCLC Following First-Line Alectinib or Brigatinib

EP12.02. Sequencing Patterns and Treatment Effectiveness in ALK-positive aNSCLC Following First-Line Alectinib or Brigatinib - PDF(Abstract)

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This study aimed to analyze the sequencing patterns and treatment effectiveness in ALK-positive advanced non-small-cell lung cancer (aNSCLC) patients who received first-line alectinib or brigatinib. The National Comprehensive Cancer Network guidelines recommend these second-generation ALK inhibitors (ALKis) as the preferred first-line treatment for ALK-positive aNSCLC. However, there is limited data on real-world treatment patterns of next-generation ALKis.<br /><br />The study used electronic health records from the Flatiron Health database to conduct a retrospective observational cohort study. The analysis included patients with ALK-rearrangement positive aNSCLC who were treated with alectinib or brigatinib as first-line therapy from June 2017 to December 2020. Patients who had received other systemic therapies for metastatic disease were excluded.<br /><br />The study found that out of 229 patients, 97% initiated first-line treatment with alectinib and 3% with brigatinib. The median time-to-treatment discontinuation (TTD) for first-line therapy was 22.8 months. Among patients who discontinued first-line treatment, 31% did not receive second-line treatment, primarily due to death. Among those who did receive second-line treatment, lorlatinib was the most common choice (51%), followed by brigatinib (12%) and chemotherapy-based regimens (11%). The median TTD for second-line therapy was 6.6 months.<br /><br />The study also assessed the total time on sequential ALKi therapy, which was found to be a median of 33.3 months. The results suggest that the most efficacious treatment for ALK-positive aNSCLC should be used upfront, as treatment duration was shorter in the second-line than in the first-line.<br /><br />Overall, the findings indicate that between 2017 and 2022, the most common treatment sequence for ALK-positive aNSCLC was first-line alectinib followed by lorlatinib. The study highlights the importance of considering real-world treatment patterns and effectiveness when making treatment decisions for ALK-positive aNSCLC patients.

Asset Subtitle

Jessica Bauman

Meta Tag

Speaker Jessica Bauman

Topic Metastatic NSCLC: Targeted Therapy - FUSIONS

Keywords

sequencing patterns

treatment effectiveness

ALK-positive

aNSCLC

alectinib

brigatinib

real-world treatment patterns

second-line treatment

lorlatinib

treatment decisions