P3.02a-021 Clinical Benefit of Continuing Crizotinib Therapy after Initial Disease Progression in Chinese Patients with Advanced ALK -Rearranged NSCLC: Topic: ALK Clinical

Abstract

Although most patients with ALK-positive non‒small-cell lung cancer (NSCLC) who benefit from treatment with crizotinib ultimately develop progressive disease (PD), continuing crizotinb beyond the initial PD (CBPD) in these patients may be beneficial. In this retrospective study, we investigated whether Chinese patients with advanced ALK-positive NSCLC benefit from CBPD, including patients with CNS progression and those who had received local therapy, and whether any factors are predictive of a longer post-initial progression-free survival time (PFS2). Data on 33 patients with ALK-positive NSCLC who had achieved disease control with initial crizotinib therapy were studied. The impact of continued crizotinib therapy (defined as >3 weeks of crizotinib treatment after the first documentation of PD) on the patients’ PFS2 time was assessed after adjusting for potential confounding factors. With initial crizotinib therapy, the objective response rate (ORR) and median PFS time (PFS1) in the 33 patients studied were 63.6% and 8.6 months, respectively (Figure 1). The brain was the most commonly involved disease progression site (n = 20; 60.6%); 14 patients (42.4%) received local therapy before and after crizotinib. With continued crizotinib therapy after the first documentation of PD, the median PFS2 time for all 33 patients was 16 weeks (Figure 1), and in those with CNS progression but systemic disease control it was 30 weeks. Patients who received local therapy after disease progression had a significantly longer PFS2 time compared with those who did not (p = 0.039). Multivariable Cox regression analysis showed that the PFS1 time with initial crizotinib treatment and local therapy were independent predictors of PFS2. This study provides further evidence of the benefit of continuing crizotinib therapy in Chinese patients with progressive ALK-positive NSCLC. Patients with a longer PFS1 and those who received local brain therapy had better survival with continued crizotinib therapy.