Real-World Treatment and Outcomes in ALK-Rearranged NSCLC: Results From a Large U.S.-Based Database

Chazan, G; Franchini, F; Shah, R; Alexander, M; John, A; IJzerman, M; Solomon, B

Author(s): Chazan, G; Franchini, F; Shah, R; Alexander, M; John, A; IJzerman, M; Solomon, B;
Details: Publication Year 2024-08,Volume 5,Issue #8,Page 100662
Journal Title: JTO Clinical and Research Reports
Publication Type: Research article
Abstract: INTRODUCTION: ALK-rearranged advanced NSCLC (aNSCLC) represents 4% of all NSCLCs, and multiple ALK-targeted therapies (ALK-inhibitors) are now available for use. Little is known about changes in treatment patterns, or how prognostic factors and sequence of therapy may impact overall survival in the real-world setting. We aim to describe initial and subsequent treatments used, survival outcomes, prognostic factors, and the impact of treatment on overall survival in the largest (N = 739) real-world cohort of patients with ALK+ aNSCLC reported in the literature. METHODS: Retrospective observational cohort study with data drawn from a U.S.-based electronic health record-derived, deidentified database. Eligible patients were diagnosed with ALK+ aNSCLC between 2011-2020 and were treated in multiple different cancer clinics and across multiple geographic regions throughout the United States. RESULTS: From a cohort of 63,667 patients with aNSCLC, 739 patients with ALK+ NSCLC were eligible for analysis, median age was 63 years, 54% patients were female, and 85% were managed in community setting. More than 168 different treatment sequences were observed, and treatment utilization changed over time. Cohort median overall survival was 37 months (95% confidence interval: 33-45). Positive prognostic factors were as follows: never-smoking history, younger age, treatment in an academic setting, and initial early stage at diagnosis. Initial treatment with a second-generation ALK-inhibitor was associated with improved survival compared with chemotherapy. CONCLUSIONS: For people with ALK+ aNSCLC, this study has identified several important clinical prognostic factors and is practice affirming; first-line treatment with a second-generation ALK-inhibitor improves survival compared with chemotherapy.
Publisher: Elsevier
Keywords: ALK+ lung cancer; Prognostic factors; Real-world; Treatment sequence
Department(s): Health Services Research; Pharmacy; Medical Oncology
Publisher's Version: https://doi.org/10.1016/j.jtocrr.2024.100662
Open Access at Publisher's Site: https://doi.org/10.1016/j.jtocrr.2024.100662
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-09-10 04:36:51

Last Modified: 2024-09-10 04:41:31