435P - Real-world data on treatment patterns and survival among ALK+ NSCLC patients in Japan. Treatment patterns and survival among ALK+ NSCLC patients in...

Date 18 November 2017
Event ESMO Asia 2017 Congress
Session Poster lunch
Topics Anti-Cancer Agents & Biologic Therapy
Biomarkers
Non-Small-Cell Lung Cancer, Metastatic
Lung and other Thoracic Tumours
Personalised Medicine
Presenter Takashi Seto
Citation Annals of Oncology (2017) 28 (suppl_10): x124-x143. 10.1093/annonc/mdx671
Authors T. Seto1, K. Nosaki1, R. Toyozawa1, K. Taguchi2, M. Edagawa1, S. Shimamatsu1, G. Toyokawa1, F. Hirai1, M. Yamaguchi1, Y. Takeda1, M. Takenoyama1, Y. Ichinose1
  • 1Department Of Thoracic Oncology, National Kyushu Cancer Center, 811-1395 - FUKUOKA/JP
  • 2Department Of Pathology, National Kyushu Cancer Center, 811-1395 - FUKUOKA/JP

Abstract

Background

Three ALK inhibitors (ALKi) are approved in Japan for treatment of patients with ALK-positive (ALK+) advanced or metastatic non-small cell lung cancer (NSCLC). However, the optimal sequence of therapy with ALKi is unclear. The objective of this study was to provide real-world data on the treatment patterns and survival among ALK+ NSCLC patients.

Methods

ALK+ patients treated with ALKi in our institute were included in this retrospective analysis. Data on the treatment patterns and outcomes were collected from medical records.

Results

In total, 60 patients were included. The median age at the diagnosis was 52.5 years, with 60% female and 65% non-smokers. The first treatment was chemotherapy in 67% and ALKi in 33%. The median overall survival (OS) was 186 weeks. We found differences in the OS for Crizotinib use at any line (118 weeks; presence vs. NR; absence) and first-line use of an ALKi (127 weeks; Crizotinib vs. 416 weeks; Alecitinib or Ceritinib, p = 0.0048). Table: 435P

AllmOS (weeks)P
186
CRZ in any linePresence1180.0001
AbsenceNR
First ALKiCRZ1270.0048
ALE or CER416
ALKi sequenceCRZ followed by ALE or CER2550.020
ALE followed by CERNR
Re-biopsyPerformed1860.52
Not performed165

Conclusions

The role of Crizotinib in the treatment of ALK+ NSCLC is decreasing. Alectinib followed by Ceritinib seems to be promising. Treatment decision-making based on a re-biopsy is immature at present. The development of sequential therapy with ALKi based on resistance mechanisms is urgently needed.

Clinical trial identification

Legal entity responsible for the study

Takashi Seto

Funding

None

Disclosure

T. Seto: I received honoraria from AstraZeneca, Bristol-Myers Squibb, Chugai Pharmaceutical, Eli Lilly Japan, Kissei Pharmaceutical. Kyowa Hakko Kirin, MSD, Nippon Boehringer Ingelheim, Nippon Kayaku, Ono Pharmaceutical, Pfizer Japan, Roche Singapore, Taiho Pharmaceutical and YakultHonsha. I received research funds from AstraZeneca, Astellas Pharma, Chugai Pharmaceutical, Daiichi Sankyo, Eisai, Eli Lilly Japan, Merck Serono, MSD, Nippon Boehringer Ingelheim, Novartis Pharma and Pfizer Japan. K. Nosaki: I received research funds from MSD and Novartis Pharma. I received honoraria from AstraZeneca, Chugai Pharmaceutical, Eli Lilly Japan, Kyowa Hakko Kirin, Nippon Boehringer Ingelheim, Nippon Kayaku and Ono Pharmaceutical. K. Taguchi: I received honoraria from MSD. F. Hirai: I received research fund from Novartis Pharma and honorarium from Chugai Pharmaceutical. M. Takenoyama: I received research funds from Eli Lilly Japan and Ono Pharmaceutical. I received from honoraria from Bristol-Myers Squibb, Chugai Pharmaceutical, AstraZeneca, Eli Lilly Japan and Ono Pharmaceutical.

All other authors have declared no conflicts of interest.