Next-generation ALK-TKI in NSCLC patients

Abstract

Objective The aim of the study is to investigate the therapeutic efficacy of next-generation anaplastic lynphoma kinase-tyrosine kinase inhibitor (ALK-TKI) in advanced non-small cell lung cancer (NSCLC). Methods The clinical data and outcomes of 22 patients with advanced non-small cell lung cancer who received the next generation of ALK-TKI from 2014 to 2017 in our hospital were retrospectively analyzed. Results 22 patients were included for survival analysis with 15 males and 7 females. The median age was 48 and all of them were adenocarcinoma patients.There were 12, 2, 7 and 1 patients received ceritinib, alectinib, brigatinib and lorlatinib, respectively. A total of 14 patients could be evaluated, including complete response (CR) in 2 cases, partial response (PR) in 3 cases, stable disease (SD) in 6 cases, progressive disease (PD) in 3 cases. The ORR and DCR were 35.7% and 78.6%, respectively. The median progression free survival (PFS) of the 22 NSCLC patients was 8.7 months. Progression pattern can be analyzed in 17 patients. Among them, 10 patients underwent primary progression (lung), occurring at the leading frequency (accounting for 58.8%) and followed by central nerve system (CNS) progression (accounting for 29.4%). Conclusions Next-generation ALK-TKI provide a reasonable choice for crizotinib-resistant patients. Primary progression (lung) is the leading cause for treatment failure. Multi-disciplinary integration may provide a potential choice for prolonging administration of next-generation ALK-TKI. Key words: Carcinoma, non-small-cell lung/DT; Sulfones/TU; Carbazoles/TU; Organophosphorus compounds/TU; Lactams, macrocyclic/TU