175P - ALK positive lung cancer: Clinical profile and outcomes in a developing country

Date 15 April 2016
Event European Lung Cancer Conference 2016 (ELCC) 2016
Session Poster lunch
Topics Non-small-cell lung cancer
Translational Research
Basic Principles in the Management and Treatment (of cancer)
Presenter Anant Ramaswamy
Citation Journal of Thoracic Oncology (2016) 11 (supplement 4): S57-S166. S1556-0864(16)X0004-4
Authors A. Ramaswamy1, V.M. Patil1, V. Noronha1, A. Joshi1, A. Chougule1, R. Kaushal2, L. Nayak1, V. Doshi1, A. Mahajan3, K. Prabhash1
  • 1Medical Oncology, Tata Memorial Hospital Centre, 400027 - Mumbai/IN
  • 2Pathology, Tata Memorial Hospital Centre, 400027 - Mumbai/IN
  • 3Radiology, Tata Memorial Hospital Centre, 400027 - Mumbai/IN

Abstract

Background

The performance and treatment profile of advanced EML4-ALK positive Non-small cell lung cancer (NSCLC) patients in a developing country with potentially restricted access to Crizotinib has not been evaluated systematically.

Methods

We conducted a retrospective analysis of advanced ALK positive NSCLC patients who were treated from June 2012 to September 2015. Baseline characteristics, access to Crizotinib, treatment regimens and survival were noted. The primary goal was to evaluate outcomes of advanced ALK positive NSCLC in our practice and examine the logistic constraints in procuring Crizotinib.

Results

94 patients were available for analysis. Median age was 51 years with 56.4% male patients and 19.1% smokers. 21 (22.3%) patients were started on Crizotinib upfront, 60 (63.8%) on chemotherapy, 10 (10.6%) on Tyrosine kinase inhibitors (in view of poor PS) and 3 (3.2%) patients were offered best supportive care. Common reasons for not starting Crizotinib upfront included symptomatic patients needing early initiation of therapy (23.3%), ALK not tested upfront (23.3%) and financial constraints (21.9%). 69 patients (73.4%) received Crizotinib at some of point of time during treatment. Dose interruptions (>1 week) with Crizotinib were seen in 20 patients (29%), with drug toxicity being the commonest reason (85%). Median Progression free survival (PFS) on first line therapy for the entire cohort was 10 months (95% Confidence Interval [CI] 6.57–13.43 months), with a significant difference between patients receiving Crizotinib and those who did not ever receive Crizotinib (10 months vs. 2 months, p = 0.028). There was no difference in PFS whether Crizotinib was received upfront or later (12 months vs 10 months, p = 0.159). Patients with an ECOG PS of >2 had a significantly reduced PFS compared to patients with PS ≤2 (1.5 months vs. 11 months, p 

Conclusions

We managed to expose majority of our ALK positive NSCLC patients to Crizotinib through the help of various support mechanisms and these patients had outcomes similar to that reported from Western literature.

Clinical trial identification

Legal entity responsible for the study

Tata Memorial Hospital

Funding

Tata Memorial Hospital

Disclosure

All authors have declared no conflicts of interest.