Lung Cancer: Lung Cancer |

ALK Rearranged Non-small Cell Lung Cancer Treatment in Clinical Practice: A Single Institution Experience FREE TO VIEW

Sojiro Kusumoto, MD; Hiroo Ishida, MD; Yasunari Kishino, MD; Yasunori Murata, MD; Yutaro Kubota, MD; Takao Shirai, MD; Toshihiro Takahashi, MD; Toshikado Kaneta, MD; Kazuyuki Hamada, MD; Tsukasa Ohnishi, MD; Hironori Sagara, MD; Yasutsuna Sasaki, MD
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Showa University, Tokyo, Japan

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A265. doi:10.1016/j.chest.2016.02.277
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SESSION TYPE: Case Report Poster

PRESENTED ON: Sunday, April 17, 2016 at 11:45 AM - 12:45 PM

INTRODUCTION: It has been demonstrated that the ALK inhibitor Crizotinib can greatly improve survival among patients with ALK rearranged NSCLC.1,2 However, this outcome is limited to the patients with a good performance status and may not be representative of the outcomes in clinical practice. There are few reports on clinical experiences of the ALK rearranged NSCLC treatment.

CASE PRESENTATION: Twelve patients with ALK rearranged NSCLC were retrospectively evaluated as a single institution experience. The median age was 56 (range 29-80) years, and 7 of 12 (58.8%) patients were male; furthermore, all the patients had adenocarcinoma. Although our experience is limited to a small number of patients with ALK rearranged NSCLC, all patients were symptomatic, and 5 of 12 (42%) had poor performance status (ECOG performance status 2 or 3) at the diagnosis. More than half of the total number of patients (7 of 12; 58.8%) experienced an oncology emergency. The time to treatment failure after crizotinib administration in patients with a poor performance status was significantly shorter than that in patients with a good performance status. [1.0 months (95%CI, 1.0-2.0) in vs 12 months (95%CI, 7.0-not determined) respectvely, p=0.0006] The overall survival was significantly longer in patients with a good performance status as compared to that in patients with a poor performance status [6.5 months (95%CI, 6-not determined) vs, 49 months (95%CI, 16-59), respectively; p=0.0076].

DISCUSSION: A shorter time to treatment failure after crizotinib administration because of severe adverse events or disease progression in patient with poor performance status was likely responsible for the poor prognosis in this group.

CONCLUSIONS: For ALK rearranged NSCLC treatment in clinical practice consideration of a modified therapeutic strategy for patients who are critically ill or have a poor performance status should be considered.

Reference #1: Alice T Shaw, Beow Y Yeap, Benjamin J Solomon, et al. Effect of crizotinib on overall survival in patients with advanced non-small-cell lung cancer harbouring ALK gene rearrangement: a retrospective analysis. Lancet Oncol 2011; 12: 1004-12.

Reference #2: Benjamin J. Solomon, Tony mok, Dong-Wan Kim et al. First-Line Crizotinib versus Chemotherapy in ALK-Positive Lung Cancer. N Engl J Med 2014;371:2167-77.

DISCLOSURE: The following authors have nothing to disclose: Sojiro Kusumoto, Hiroo Ishida, Yasunari Kishino, Yasunori Murata, Yutaro Kubota, Takao Shirai, Toshihiro Takahashi, Toshikado Kaneta, Kazuyuki Hamada, Tsukasa Ohnishi, Hironori Sagara, Yasutsuna Sasaki

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