4070 - Crizotinib vs Platinum-based Chemotherapy as First-line Treatment for Advanced Non-small Cell Lung Cancer with Different ROS1 Fusion Variants

Background

ROS1 rearrangement, a novel specific molecular subtype of non-small cell lung cancer (NSCLC), has become a validated therapeutic target. However, the efficacy of crizotinib and platinum-based chemotherapy as first-line treatment between different ROS1 fusion variants in advanced Chinese NSCLC patients has not yet been fully elucidated. This study explored which treatment regimen would be better in such patients.

Methods

Retrospective real-world analyses of clinical and treatment outcome with ROS1-positive advanced NSCLC patients from multi-center study were explored in China, from Jan 9^th 2011 to Jan 1^st 2019. The study evaluated first-line regimens including crizotinib treatment and platinum-based chemotherapy. The primary endpoint was progression-free survival (PFS), and second endpoints were the objective response rate (ORR) and overall survival (OS). Kaplan-Meier survival analysis was carried out by using SPSS 16.0.

Results

A total of 102 patients, 75 (73.5%) females and 27 (26.5%) males were enrolled. The median age of patients was 52 years and 99 (97.1%) were identified with adenocarcinoma type. 57 cases were administered crizotinib and 45 received platinum-based chemotherapy. For the first-line treatment, the median PFS was significantly longer for crizotinib treatment compared with platinum-based chemotherapy (median,15.0 vs. 9.7months, p = 0.006), respectively. 58 cases were confirmed ROS1 fusion variants by next-generation sequence (NGS) including CD74 fusion (n = 32) and non-CD74 fusion(n = 26). Patients receiving crizotinib with the CD74 fusion had a significant longer PFS than those by platinum-based chemotherapy (median,18.3 vs. 8.8months, p = 0.002); in contrast, a statistical significance was not observed on PFS in the non-CD74 fusion subgroup (12.2 vs. 9.0 months, p = 0.544). The ORR of crizotinib treatment was higher than that of platinum-based chemotherapy (80.7% vs. 55.6%, p = 0.006). OS was not reached owing to immature data.

Conclusions

Crizotinib as first-line treatment tends to have more benefit than platinum-based chemotherapy for advanced Chinese NSCLC patients with CD74 ROS1 fusion variant.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.