Kyuhwan Kim, Kyu Yean Kim, Hye Seon Kang, Ah Young Shin, Sung Kyoung Kim, Chan Kwon Park, Sang Haak Lee, Seung Joon Kim, Jeong Uk Lim, Chang Dong Yeo
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Key outcomes such as time to discontinuation (TTD), duration of response (DOR), overall survival (OS), and objective response rate (ORR) were analyzed.</p><p><strong>Results: </strong>A total of 143 patients were included (107 treated with alectinib, 36 with brigatinib). Alectinib was more frequently used as a first-line treatment (71% vs 44.4% for brigatinib, <i>p</i> = 0.008). Prior crizotinib treatment was more frequent in the brigatinib group (52.8% vs 22.4% for alectinib, <i>p</i> < 0.001). The best ORR was similar between the groups (84.1% for alectinib vs 83.3% for brigatinib, <i>p</i> = 0.518). The median TTD was 57.8 months (95% confidence interval (CI): 29.0-86.7) for alectinib and 39.6 months (95% CI: 21.7-57.4) for brigatinib (<i>p</i> = 0.462). No significant differences were observed in intracranial TTD, intracranial DOR, or OS between the groups. Prior crizotinib treatment significantly shortened TTD for second-generation TKIs (<i>p</i> = 0.025), but the overall TKI treatment duration did not show a significant difference between patients who received frontline second-generation ALK TKIs and those who received second-generation ALK TKIs sequentially after crizotinib.</p><p><strong>Conclusion: </strong>Alectinib and brigatinib demonstrated comparable efficacy in ALK-positive advanced NSCLC. Undergoing crizotinib followed by a second-generation TKI was not significantly different from initiating a second-generation TKI without prior crizotinib in terms of outcomes.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251316200"},"PeriodicalIF":4.2000,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806492/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparative analysis of alectinib and brigatinib in real-world treatment of advanced NSCLC with ALK rearrangements.\",\"authors\":\"Kyuhwan Kim, Kyu Yean Kim, Hye Seon Kang, Ah Young Shin, Sung Kyoung Kim, Chan Kwon Park, Sang Haak Lee, Seung Joon Kim, Jeong Uk Lim, Chang Dong Yeo\",\"doi\":\"10.1177/17588359251316200\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objectives: </strong>This study aimed to compare the efficacy of the second-generation anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) alectinib and brigatinib in the treatment of advanced non-small-cell lung cancer (NSCLC) with ALK rearrangements based on real-world data.</p><p><strong>Design and methods: </strong>We conducted a multicenter retrospective study using the Clinical Data Warehouse from seven university hospitals affiliated with the Catholic Medical Center. Patients diagnosed with ALK-positive advanced NSCLC and treated with alectinib or brigatinib were included. Key outcomes such as time to discontinuation (TTD), duration of response (DOR), overall survival (OS), and objective response rate (ORR) were analyzed.</p><p><strong>Results: </strong>A total of 143 patients were included (107 treated with alectinib, 36 with brigatinib). Alectinib was more frequently used as a first-line treatment (71% vs 44.4% for brigatinib, <i>p</i> = 0.008). Prior crizotinib treatment was more frequent in the brigatinib group (52.8% vs 22.4% for alectinib, <i>p</i> < 0.001). The best ORR was similar between the groups (84.1% for alectinib vs 83.3% for brigatinib, <i>p</i> = 0.518). The median TTD was 57.8 months (95% confidence interval (CI): 29.0-86.7) for alectinib and 39.6 months (95% CI: 21.7-57.4) for brigatinib (<i>p</i> = 0.462). No significant differences were observed in intracranial TTD, intracranial DOR, or OS between the groups. Prior crizotinib treatment significantly shortened TTD for second-generation TKIs (<i>p</i> = 0.025), but the overall TKI treatment duration did not show a significant difference between patients who received frontline second-generation ALK TKIs and those who received second-generation ALK TKIs sequentially after crizotinib.</p><p><strong>Conclusion: </strong>Alectinib and brigatinib demonstrated comparable efficacy in ALK-positive advanced NSCLC. 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引用次数: 0
摘要
背景和目的：本研究旨在比较第二代间变性淋巴瘤激酶（ALK）酪氨酸激酶抑制剂（TKIs）阿勒替尼和布加替尼治疗晚期非小细胞肺癌（NSCLC）的疗效，基于现实世界数据。设计和方法：我们使用天主教医学中心附属七所大学医院的临床数据仓库进行了一项多中心回顾性研究。诊断为alk阳性晚期NSCLC并接受alec替尼或布加替尼治疗的患者被纳入研究。主要结果如停药时间（TTD）、反应持续时间（DOR）、总生存期（OS）和客观缓解率（ORR）进行分析。结果：共纳入143例患者（107例阿勒替尼治疗，36例布加替尼治疗）。阿勒替尼更常被用作一线治疗（71%比布加替尼44.4%,p = 0.008）。布加替尼组先前接受克唑替尼治疗的频率更高（52.8% vs 22.4%, p p = 0.518）。阿勒替尼的中位TTD为57.8个月（95%可信区间（CI）： 29.0-86.7），布加替尼的中位TTD为39.6个月（95% CI: 21.7-57.4） （p = 0.462）。两组间颅内TTD、颅内DOR或OS均无显著差异。既往克唑替尼治疗显著缩短了二代TKI的TTD (p = 0.025)，但一线接受第二代ALK TKI治疗的患者与在克唑替尼治疗后连续接受第二代ALK TKI治疗的患者在TKI总治疗时间上无显著差异。结论：阿勒替尼和布加替尼对alk阳性晚期NSCLC的疗效相当。在结果方面，接受克唑替尼治疗后接受第二代TKI治疗与未接受克唑替尼治疗的第二代TKI治疗没有显著差异。
Comparative analysis of alectinib and brigatinib in real-world treatment of advanced NSCLC with ALK rearrangements.
Background and objectives: This study aimed to compare the efficacy of the second-generation anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) alectinib and brigatinib in the treatment of advanced non-small-cell lung cancer (NSCLC) with ALK rearrangements based on real-world data.
Design and methods: We conducted a multicenter retrospective study using the Clinical Data Warehouse from seven university hospitals affiliated with the Catholic Medical Center. Patients diagnosed with ALK-positive advanced NSCLC and treated with alectinib or brigatinib were included. Key outcomes such as time to discontinuation (TTD), duration of response (DOR), overall survival (OS), and objective response rate (ORR) were analyzed.
Results: A total of 143 patients were included (107 treated with alectinib, 36 with brigatinib). Alectinib was more frequently used as a first-line treatment (71% vs 44.4% for brigatinib, p = 0.008). Prior crizotinib treatment was more frequent in the brigatinib group (52.8% vs 22.4% for alectinib, p < 0.001). The best ORR was similar between the groups (84.1% for alectinib vs 83.3% for brigatinib, p = 0.518). The median TTD was 57.8 months (95% confidence interval (CI): 29.0-86.7) for alectinib and 39.6 months (95% CI: 21.7-57.4) for brigatinib (p = 0.462). No significant differences were observed in intracranial TTD, intracranial DOR, or OS between the groups. Prior crizotinib treatment significantly shortened TTD for second-generation TKIs (p = 0.025), but the overall TKI treatment duration did not show a significant difference between patients who received frontline second-generation ALK TKIs and those who received second-generation ALK TKIs sequentially after crizotinib.
Conclusion: Alectinib and brigatinib demonstrated comparable efficacy in ALK-positive advanced NSCLC. Undergoing crizotinib followed by a second-generation TKI was not significantly different from initiating a second-generation TKI without prior crizotinib in terms of outcomes.
期刊介绍：
Therapeutic Advances in Medical Oncology is an open access, peer-reviewed journal delivering the highest quality articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of cancer. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in medical oncology, providing a forum in print and online for publishing the highest quality articles in this area. This journal is a member of the Committee on Publication Ethics (COPE).
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