2024 World Conference on Lung Cancer (WCLC) - Posters-P1.12B.03 Real-World Outcomes of 2L ALK TKIs Following 1L Brigatinib for Patients with ALK+ NSCLC from the ALTA-1L Trial

P1.12B.03 Real-World Outcomes of 2L ALK TKIs Following 1L Brigatinib for Patients with ALK+ NSCLC from the ALTA-1L Trial

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The study presented at the WCLC 2024 in San Diego focused on real-world outcomes following first-line (1L) brigatinib treatment in patients with anaplastic lymphoma kinase-positive (ALK) non-small cell lung cancer (NSCLC). Brigatinib has been shown to have superior clinical efficacy compared to the first-generation ALK inhibitor, crizotinib, as evidenced in the phase III ALTA-1L trial. This analysis took a closer look at patients who, after completing the ALTA-1L trial, received second-line (2L) ALK tyrosine kinase inhibitors (TKIs) after stopping 1L brigatinib.<br /><br />A total of 48 patients from 20 sites worldwide were included in the study. Most of these, 40 patients (83.3%), continued with systemic anticancer therapies after 1L brigatinib. Specifically, 30 patients were part of the subgroup receiving 2L ALK TKIs, and among them, 53.3% received lorlatinib and 26.7% alectinib. Key outcomes such as real-world progression-free survival (rwPFS), real-world time to treatment discontinuation (rwTTD), and overall survival (OS) were measured using the Kaplan-Meier method.<br /><br />Results indicated that patients experienced prolonged clinical benefits with 2L ALK TKIs. Notably, patients who initially responded to brigatinib also had longer timeframes before discontinuing subsequent therapies. For example, the median rwTTD for 2L lorlatinib was observed to be 37.2 months. Subgroup analyses highlighted that 1L responders generally had better long-term outcomes in comparison to non-responders.<br /><br />However, the study acknowledged limitations like possible sample bias due to the non-representative nature of the sampled sites and possible under-reporting from retrospective data analysis. Despite these limitations, the study remains one of the first long-term evaluations post-1L brigatinib, providing insights into the effectiveness of subsequent ALK TKIs in real-world settings.

Asset Subtitle

Myung-Ju Ahn

Meta Tag

Speaker Myung-Ju Ahn

Topic Metastatic NSCLC – Targeted Therapy

Keywords

WCLC 2024

brigatinib

ALK-positive NSCLC

real-world outcomes

ALTA-1L trial

ALK TKIs

lorlatinib

alectinib

Kaplan-Meier method

progression-free survival