2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.17A.01 The Cumulative Incidence of Brain Metastases in US Medicare Patients with ALK+ mNSCLC Treated with Second-generation ALK TKIs

EP.17A.01 The Cumulative Incidence of Brain Metastases in US Medicare Patients with ALK+ mNSCLC Treated with Second-generation ALK TKIs

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Pdf Summary

The study led by Lyudmila Bazhenova, MD, and sponsored by Pfizer, focuses on the incidence and impact of brain metastases (BM) in patients with anaplastic lymphoma kinase-positive metastatic non-small-cell lung cancer (ALK mNSCLC) treated with second-generation ALK tyrosine kinase inhibitors (TKIs) such as alectinib and brigatinib. This retrospective cohort study utilizes Medicare data from 2017-2022 to assess the incidence of BM and its association with mortality among this patient population.<br /><br />ALK gene rearrangements occur in approximately 3-5% of NSCLC cases, and BM are common among these patients, occurring either at diagnosis or during disease progression. The study aimed to estimate BM incidence and its impact on patient survival. The study cohort comprised patients without pre-existing BM who were followed to identify incident BM and mortality. Results showed that 28% of patients had BM at baseline, and a cumulative 20% developed BM over five years. <br /><br />The study found that patients experiencing BM during follow-up had a significantly higher risk of mortality, with a hazard ratio (HR) of 2.59. Baseline BM patients had a higher incidence of death at 68% compared to 65% in those at risk for developing BM.<br /><br />Key limitations included the use of claims data, which are not primarily collected for research and may lack comprehensive clinical detail, and potential limited generalizability to non-Medicare populations or younger patients. Despite these limitations, the study highlights the critical need for treatment options with improved central nervous system activity to manage and prevent BM in ALK mNSCLC patients using second-generation ALK TKIs.

Asset Subtitle

Lyudmila Bazhenova

Meta Tag

Speaker Lyudmila Bazhenova

Topic Global Health, Health Services, and Health Economics

Keywords

brain metastases

ALK mNSCLC

tyrosine kinase inhibitors

alectinib

brigatinib

Medicare data

mortality

hazard ratio

central nervous system

treatment options