Jacques Cadranel1, Keunchil Park2, Oscar Arrieta3, Miklos Pless4, Edmond Bendaly5, Dony Patel6, Medha Sasane7, Adam Nosal8, Elyse Swallow9, Philip Galebach9, Andrew Kageleiry9, Karen Stein7, Ravi Degun6, Jie Zhang7. 1. Assistance Publique Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie Université Paris VI, Paris, France. Electronic address: jacques.cadranel@aphp.fr. 2. Samsung Medical Center Sungkyunkwan University School of Medicine, Innovative Cancer Medicine Institute Division of Hematology/Oncology, Seoul, Republic of Korea. 3. Instituto Nacional de Cancerología, Lung Cancer Department, Mexico City, Mexico. 4. Kantonsspital Winterthur, Departement Medizin Medizinische Onkologie, Winterthur, Switzerland. 5. Marion General Hospital, Medical Oncology, Marion, USA. 6. Navigant Consulting Inc., Life Sciences, London, United Kingdom. 7. Novartis Pharmaceuticals Corporation, East Hanover, USA. 8. Novartis Farma S.p.A., Pricing/Health Economics & Access: Oncology Region Europe, Origgio, Italy. 9. Analysis Group Inc., Health Economics and Outcomes Research, Boston, USA.
Abstract
OBJECTIVES: Second-generation ALK inhibitors are recently available for ALK+ non-small cell lung cancer (NSCLC) patients previously treated with crizotinib. This study described characteristics, treatment sequencing, and outcomes among locally advanced/metastatic crizotinib-experienced ALK+ NSCLC patients. MATERIALS AND METHODS: From July 2014 to June 2015, a retrospective patient chart review was conducted among physicians from the US, EU, Korea, and Latin America. Participating clinicians identified their ALK+ NSCLC patients who received crizotinib and reported on their clinical characteristics, treatments, and survival using a pre-defined case report form. Kaplan-Meier analyses were used to describe overall survival (OS) and clinician-defined progression-free survival (PFS). RESULTS: Participating clinicians reviewed charts of 158 ALK+ NSCLC patients treated with crizotinib during the study period. Crizotinib was most commonly received in the second-line setting (41% of patients), though this varied across geographical regions. Roughly half (53%) of the patients who discontinued crizotinib received further antineoplastic therapy; second-generation ALK inhibitors (44%) and chemotherapy (42%) regimens were used most frequently. Following crizotinib discontinuation, median OS was 8.2 months. Among patients who did not initiate a second-generation ALK inhibitor following crizotinib, median OS was 4.9 months; among those who did, median OS was not reached. Among patients who received chemotherapy immediately following crizotinib discontinuation, time to clinician-defined PFS from post-crizotinib chemotherapy initiation was 3.6 months. CONCLUSION: Following crizotinib discontinuation, many patients received no further antineoplastic therapy, and OS was poor among patients who did not receive a second-generation ALK inhibitor. Recently available second-generation ALK inhibitors may provide important treatment options for ALK+ NSCLC patients.
OBJECTIVES: Second-generation ALK inhibitors are recently available for ALK+ non-small cell lung cancer (NSCLC) patients previously treated with crizotinib. This study described characteristics, treatment sequencing, and outcomes among locally advanced/metastatic crizotinib-experienced ALK+ NSCLCpatients. MATERIALS AND METHODS: From July 2014 to June 2015, a retrospective patient chart review was conducted among physicians from the US, EU, Korea, and Latin America. Participating clinicians identified their ALK+ NSCLCpatients who received crizotinib and reported on their clinical characteristics, treatments, and survival using a pre-defined case report form. Kaplan-Meier analyses were used to describe overall survival (OS) and clinician-defined progression-free survival (PFS). RESULTS: Participating clinicians reviewed charts of 158 ALK+ NSCLCpatients treated with crizotinib during the study period. Crizotinib was most commonly received in the second-line setting (41% of patients), though this varied across geographical regions. Roughly half (53%) of the patients who discontinued crizotinib received further antineoplastic therapy; second-generation ALK inhibitors (44%) and chemotherapy (42%) regimens were used most frequently. Following crizotinib discontinuation, median OS was 8.2 months. Among patients who did not initiate a second-generation ALK inhibitor following crizotinib, median OS was 4.9 months; among those who did, median OS was not reached. Among patients who received chemotherapy immediately following crizotinib discontinuation, time to clinician-defined PFS from post-crizotinib chemotherapy initiation was 3.6 months. CONCLUSION: Following crizotinib discontinuation, many patients received no further antineoplastic therapy, and OS was poor among patients who did not receive a second-generation ALK inhibitor. Recently available second-generation ALK inhibitors may provide important treatment options for ALK+ NSCLCpatients.