Crizotinib in Metastatic ALK mutant Non-small Cell Lung Cancer Patients: A Single Centre Experience

I. Dogan, N. Khanmammadov, Melin Aydan Ahmed, Anıl Yıldız, P. Saip, A. Aydıner, S. Vatansever
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Abstract

The goal of this study was to evaluate the efficacy of crizotinib in patients with ALK-positive metastatic lung cancer. The patients' data were analyzed retrospectively. Cox regression and Kaplan-Meier methods were used to perform survival analyses. A total of 25 patients were involved in the study. Thirteen (52%) patients were male, and the average age was 55 (range, 30-80). 23 (92%) of the patients were de-novo metastatic. Brain metastases were present in 32% and liver metastases in 20% of the patients. Before crizotinib treatment, 64% of the patients had received chemotherapy, and 20% had received palliative radiotherapy. Progression-free survival was found as 16.8 (CI 95%, 5.7-27.9) months. Grade 1-2 side effects were detected in 36% of the patients, and grade 3-4 side effects were observed in 12%. After progression, 13 (52%) patients received 2nd series ALK inhibitors (alectinib, ceritinib, and lorlatinib) or chemotherapy. The median overall survival (OS) was found as 44.2 (95% CI, 28.5-59.9) months. The four-year OS rate was 37.4%. In the multivariate analysis, the ALK positivity ratio (p=0.02) was determined as a statistically significant factor affecting OS. We showed efficacy data of crizotinib in patients with ALK mutant metastatic non-small cell lung cancer. Crizotinib is an effective and safe therapy for patients with ALK mutant metastatic non-small cell lung cancer. Also, we found that the ALK positivity ratio was prognostic for OS.
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克唑替尼在转移性ALK突变非小细胞肺癌患者中的应用:单一中心经验
本研究的目的是评估克唑替尼对alk阳性转移性肺癌患者的疗效。回顾性分析患者资料。采用Cox回归和Kaplan-Meier方法进行生存分析。共有25名患者参与了这项研究。男性13例(52%),平均年龄55岁(30 ~ 80岁)。23例(92%)患者为重新转移。32%的患者出现脑转移,20%的患者出现肝转移。克唑替尼治疗前,64%的患者接受过化疗,20%的患者接受过姑息性放疗。无进展生存期为16.8个月(CI 95%, 5.7-27.9)。36%的患者出现1-2级不良反应,12%的患者出现3-4级不良反应。进展后,13例(52%)患者接受了第二系列ALK抑制剂(阿勒替尼、西瑞替尼和氯拉替尼)或化疗。中位总生存期(OS)为44.2个月(95% CI, 28.5-59.9)。4年生存率为37.4%。在多因素分析中,确定ALK阳性比(p=0.02)为影响OS的有统计学意义的因素。我们展示了克唑替尼对ALK突变转移性非小细胞肺癌患者的疗效数据。克唑替尼是一种有效且安全的治疗ALK突变转移性非小细胞肺癌的药物。此外,我们发现ALK阳性比率是OS的预后指标。
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