AI Article Synopsis
- Alectinib significantly improves survival in patients with ALK rearrangement-positive non-small cell lung cancer (NSCLC) who have a poor performance status (PS), showing consistent benefits even with central nervous system metastases.
- The LOGiK 1401 study involved 18 patients with a PS of 2, 3, or 4, revealing a median survival time of 30.3 months and a 3-year overall survival rate of 43.8%.
- The results indicate that alectinib is an effective treatment option for these patients, who typically do not qualify for chemotherapy.
Article Abstract
Lessons Learned: Alectinib confers a pronounced survival benefit in patients with ALK rearrangement-positive non-small cell lung cancer and a poor performance status. Survival benefit of alectinib for patients with a poor performance status was consistent regardless of the presence of central nervous system metastases.
Background: We previously reported a marked objective response rate (ORR) and safety for alectinib treatment in patients with ALK rearrangement-positive non-small cell lung cancer (NSCLC) and a poor performance status (PS) in the Lung Oncology Group in Kyushu (LOGiK) 1401 study. It remained unclear, however, whether alectinib might also confer a long-term survival benefit in such patients.
Methods: Eighteen patients with ALK rearrangement-positive advanced NSCLC and a PS of 2, 3, or 4 (n = 12, 5, and 1, respectively) were enrolled in LOGiK1401 between September 2014 and December 2015 and received alectinib. We have now updated the survival data for the study.
Results: The median follow-up time for all patients was 27.3 months. The median progression-free survival (PFS) was 16.2 months (95% confidence interval [CI], 7.1-30.8 months), and the median survival time (MST) and the 3-year overall survival rate were 30.3 months (95% CI, 11.5 months to not reached) and 43.8% (95% CI, 20.8-64.7%), respectively. This survival benefit was similarly manifest in patients with a PS of 2 (MST, 20.5 months) and those with a PS of ≥3 (MST, not reached). PFS did not differ between patients with or without central nervous system (CNS) metastases at baseline (median of 17.5 and 16.2 months, respectively, p = .886).
Conclusion: Alectinib showed a pronounced survival benefit for patients with ALK rearrangement-positive NSCLC and a poor PS regardless of the presence of CNS metastases, a patient population for which chemotherapy is not indicated.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7160311 | PMC |
| http://dx.doi.org/10.1634/theoncologist.2019-0728 | DOI Listing |
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