2023 World Conference on Lung Cancer (Posters)-P2.10. Real-World Outcome of Metastatic ALK-Positive Non-Small Cell Lung Cancer Treated with Tyrosine Kinase Inhibitors

P2.10. Real-World Outcome of Metastatic ALK-Positive Non-Small Cell Lung Cancer Treated with Tyrosine Kinase Inhibitors - PDF(Abstract)

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This study examined the real-world outcomes of patients with metastatic ALK-positive non-small cell lung cancer (NSCLC) who were treated with tyrosine kinase inhibitors (TKIs). The researchers analyzed a cohort of 150 Swedish patients who received at least one line of ALK TKI treatment between January 2009 and December 2021. The patients' ALK-positivity was assessed using fluorescent in situ hybridization (FISH) or immunohistochemistry (IHC). Resistance mechanisms were evaluated through re-biopsies of resistant tumor tissues and circulating tumor DNA (ctDNA) sequencing. <br /><br />The majority of the patients had adenocarcinoma histology and were never smokers. The most common ALK fusion variants detected were variant 1 and variant 3a/b. The median progression-free survival (PFS) and overall survival (OS) for patients treated with crizotinib were 8.0 months and 35.0 months, respectively. The median PFS for second-generation ALK TKIs was 52.0 months, and the OS was not yet reached. The overall response rate (ORR) was significantly higher in patients receiving second-generation ALK TKIs compared to crizotinib. <br /><br />Re-biopsies revealed secondary ALK mutations in 9 patients, who had worse median PFS during the next treatment line of ALK inhibitors compared to those without resistance mutations. The study showed that patients with advanced ALK-positive NSCLC had prolonged survival when treated with ALK TKIs, particularly in the first-line setting. Re-biopsies during treatment were found to be important for understanding resistance mechanisms and enhancing individualized management of the disease.

Asset Subtitle

Per Hydbring

Meta Tag

Speaker Per Hydbring

Topic Metastatic NSCLC: Targeted Therapy - FUSIONS

Keywords

metastatic ALK-positive non-small cell lung cancer

tyrosine kinase inhibitors

Swedish patients

ALK TKI treatment

resistance mechanisms

adenocarcinoma histology

ALK fusion variants

progression-free survival

crizotinib

second-generation ALK TKIs