2024 World Conference on Lung Cancer (WCLC) - Posters-P1.12B.04 Central Nervous System (CNS) Progression on CNS Penetrable ALK TKI: Real-World Practice Patterns and Patient Outcomes

P1.12B.04 Central Nervous System (CNS) Progression on CNS Penetrable ALK TKI: Real-World Practice Patterns and Patient Outcomes

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This study investigates real-world practice patterns and outcomes for patients with ALK rearranged non-small cell lung cancer (NSCLC) who develop central nervous system (CNS) progression while on CNS-penetrable tyrosine kinase inhibitor (TKI) therapy. Given the lack of a standardized treatment strategy for managing CNS progression in these patients, the study aims to provide insights into various management strategies and their outcomes.<br /><br />The research was conducted as a retrospective study in an academic cancer center, focusing on ALK rearranged NSCLC patients who experienced CNS progression while on CNS-penetrable TKI therapy. The study classified patients into three groups based on their management strategy: 1) TKI altered group, which included patients who had their TKI switched or dosage increased; 2) TKI unaltered group, where the TKI was continued at the same or lower dose; and 3) TKI discontinued group, where TKI treatment was stopped altogether.<br /><br />Key findings highlighted that changing or increasing the TKI dosage proved to be a feasible salvage strategy for patients experiencing leptomeningeal progression or concurrent systemic progression alongside CNS issues. The study revealed various patterns of disease progression, with significantly different baseline characteristics and outcomes across the three groups.<br /><br />Through statistical analyses including Fisher’s exact tests and Kaplan-Meier survival curves, it was determined that continuing TKI therapy in some form could be beneficial for specific patients. This study marks the first attempt to systematically characterize practice patterns in this setting and supports the continued use of TKI therapy for select patients with ALK rearranged NSCLC facing CNS progression, thus contributing to more informed clinical decisions and management strategies.

Asset Subtitle

Surbhi Singhal

Meta Tag

Speaker Surbhi Singhal

Topic Metastatic NSCLC – Targeted Therapy

Keywords

ALK rearranged NSCLC

CNS progression

tyrosine kinase inhibitor

TKI therapy

real-world practice patterns

management strategies

retrospective study

leptomeningeal progression

survival analysis

clinical decision-making