Clinical treatment patterns, molecular characteristics and survival outcomes of ROS1-rearranged non-small cell lung cancer: A large multicenter retrospective study

• Published in: Lung cancer (Amsterdam, Netherlands) Netherlands), 2024-06, Vol.192, p.107827, Article 107827
• Main Authors: Huang, Zhe, Zhang, Yuda, Xu, Qinqin, Song, Lianxi, Li, Yizhi, Guo, Wenhuan, Lin, Shaoding, Jiang, Wenjuan, Wang, Zhan, Deng, Li, Qin, Haoyue, Zhang, Xing, Tong, Fan, Zhang, Ruiguang, Liu, Zhaoyi, Zhang, Lin, Yu, Juan, Dong, Xiaorong, Gong, Qian, Deng, Jun, Chen, Xue, Wang, Jing, Zhang, Gao, Yang, Nong, Zeng, Liang, Zhang, Yongchang
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Aminopyridines; Antigens, Differentiation, B-Lymphocyte; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - genetics; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - pathology; China - epidemiology; Crizotinib - therapeutic use; Drug Resistance, Neoplasm - genetics; Female; Fusion partner; Gene Rearrangement; Histocompatibility Antigens Class II; Humans; Lactams; Lung Neoplasms - drug therapy; Lung Neoplasms - genetics; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Male; Middle Aged; NSCLC; Prognosis; Protein Kinase Inhibitors - therapeutic use; Protein-Tyrosine Kinases - genetics; Proto-Oncogene Proteins - genetics; Pyrazoles - therapeutic use; Resistance; Retrospective Studies; ROS1 rearrangement; Survival; Survival Rate
• ISSN: 0169-5002; 1872-8332; 1872-8332
• DOI: 10.1016/j.lungcan.2024.107827

•Clinical outcome of the largest cohort study with 550 ROS1 rearrangement lung cancer in China.•ROS1 rearrangement was found to occur in 1.8 % in 4 centers in China.•CD74 as the most common ROS1 fusion partner: accounting for 45.8 % of cases.•Crizotinib was predominantly used as the first-line treatment (73.9 % of patients) with superior survival outcomes.•Sequential tyrosine kinase inhibitor (TKI) therapy after first-line crizotinib yielded better survival outcomes. Non-small cell lung cancer (NSCLC) harboring ROS1 rearrangements is a molecular subset that exhibits favorable responses to tyrosine kinase inhibitor (TKI) treatment than chemotherapy. This study investigated real-world treatment patterns and survival outcomes among patients with ROS1-rearranged advanced NSCLC. We conducted a retrospective analysis of patients with ROS1-rearranged advanced NSCLC treated in four different hospitals in China from August 2018 to March 2022. The study analyzed gene fusion distribution, resistance patterns, and survival outcomes. ROS1 rearrangement occurs in 1.8 % (550/31,225) of our study cohort. CD74 was the most common ROS1 fusion partner, accounting for 45.8 %. Crizotinib was used in 73.9 % of patients in the first-line treatment, and an increased use of chemotherapy, ceritinib, and lorlatinib was seen in the second-line setting. Lung (43.2 %) and brain (27.6 %) were the most common sites of progression in first-line setting, while brain progression (39.2 %) was the most common site of progression in second-line. Median overall survival was 46 months (95 % confidence intervals: 39.6–52.4). First-line crizotinib use yielded significantly superior survival outcomes over chemotherapy in terms of progression-free (18.5 vs. 6.0; p