Real‐World Treatment Patterns and Progression‐Free Survival Associated with Anaplastic Lymphoma Kinase (ALK) Tyrosine Kinase Inhibitor Therapies for ALK+ Non‐Small Cell Lung Cancer

• Published in: The oncologist (Dayton, Ohio) Ohio), 2020-10, Vol.25 (10), p.867-877
• Main Authors: Jahanzeb, Mohammad, Lin, Huamao M., Pan, Xiaoyun, Yin, Yu, Wu, Yanyu, Nordstrom, Beth, Socinski, Mark A.
• Format: Article
• Language: English
• Subjects: Anaplastic lymphoma kinase; Carcinoma, non‐small cell lung; Health Outcomes and Economics of Cancer Care; Practice patterns, physicians; Survival analysis
• ISSN: 1083-7159; 1549-490X
• DOI: 10.1634/theoncologist.2020-0011

Background Little is known about real‐world treatment and outcomes of patients with anaplastic lymphoma kinase‐positive (ALK+) advanced non‐small cell lung cancer (NSCLC). Patients and Methods This retrospective study of the Flatiron Health EHR‐derived deidentified database included patients with a lung cancer diagnosis and confirmed advanced NSCLC who received ALK tyrosine kinase inhibitor (TKI) therapy (January 1, 2011, through June 30, 2018). Patient characteristics and treatment patterns were characterized. Real‐world progression‐free survival (rwPFS) and time to discontinuation were calculated using the Kaplan‐Meier method. Results First‐line ALK TKI therapy was administered to 581 patients (27.5% had brain metastasis on or prior to initiation) and second‐line ALK TKI therapy to 254 patients post crizotinib (45.7% had brain metastasis on or prior to second‐line ALK TKI initiation). Crizotinib (84.6%; n = 492) was the most commonly administered first‐line ALK TKI therapy. For second‐line ALK TKI post crizotinib (n = 254), 49.6% received ceritinib, 41.7% received alectinib, 5.9% received crizotinib retreatment, and 2.8% received brigatinib. Median (95% confidence interval [CI]) rwPFS was 7.47 (6.48–8.32) months for first‐line and 7.30 (5.72–8.42) months for second‐line ALK TKI. Median (95% CI) rwPFS was significantly longer among first‐line ALK TKI patients without than with brain metastasis (8.52 [7.57–10.59] vs. 4.97 [3.75–5.99] months; p