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(Slides)

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This study aimed to describe the sequencing patterns and treatment effectiveness in patients with ALK-positive advanced non-small cell lung cancer (aNSCLC) who received first-line treatment with alectinib or brigatinib. The study utilized real-world data from a retrospective analysis of patients in the Flatiron EHR database.<br /><br />The preferred first-line treatments for ALK-positive aNSCLC are alectinib, brigatinib, or lorlatinib. Second-generation ALK tyrosine kinase inhibitors (TKIs) have shown median progression-free survival (PFS) of 2-3 years, while lorlatinib has shown promising results with a 3-year PFS of 64%. After progression on second-generation TKIs, lorlatinib or chemotherapy are recommended. However, a significant proportion of patients do not receive second-line treatment due to rapid clinical deterioration.<br /><br />The study included a cohort of patients who initiated first-line treatment with alectinib or brigatinib between June 2017 and April 2021. The primary objective was to describe sequencing patterns and treatment effectiveness using time-to-treatment discontinuation (TTD). The study found that alectinib followed by lorlatinib was the most common sequence. About 36% of patients discontinued their first-line treatment within 12 months, and 42% of those who discontinued did not receive second-line treatment. The attrition rate from second-line to third-line treatment was 51%.<br /><br />The median TTD for first-line treatment was 19.6 months, and for second-line treatment, it was 7.1 months. The median total time on sequential ALK TKI therapy was 2.2 years. The duration of the sequence was driven by the effectiveness of first-line treatment.<br /><br />The study has some limitations, including incomplete information and potential loss to follow-up. The data underline the need to improve outcomes for patients with ALK-positive aNSCLC by optimizing the use of first-line treatment. Ongoing trials with third-generation ALK TKIs in the first-line setting may provide even better outcomes for these patients.

Asset Subtitle

Jessica Bauman

Meta Tag

Speaker Jessica Bauman

Topic Metastatic NSCLC: Targeted Therapy - FUSIONS

Keywords

sequencing patterns

treatment effectiveness

ALK-positive

advanced non-small cell lung cancer

aNSCLC

first-line treatment

alectinib

brigatinib

real-world data

retrospective analysis