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ePoster Display

1205P - Treatment sequencing and duration of subsequent tyrosine kinase inhibitors in ALK+ non-small cell lung cancer patients treated with brigatinib in the US

Date

16 Sep 2021

Session

ePoster Display

Presenters

Mohammad Jahanzeb

Citation

Annals of Oncology (2021) 32 (suppl_5): S949-S1039. 10.1016/annonc/annonc729

Authors

M.O. Jahanzeb1, H.M. Lin2, Y. Wu2, M. Gorritz3, C.B. McGuiness3, K. Sun3, C. Chen3, P. Zhang2, D..R. Camidge4

Author affiliations

  • 1 Hematology-oncology Department, Florida Precision Oncology - 21st Century Oncology, LLC, 33428 - Boca Raton/US
  • 2 Global Outcomes Research & Epidemiology - Oncology, Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, Cambridge/US
  • 3 Heor, IQVIA, Inc., 19462 - Plymouth Meeting/US
  • 4 Medical Oncology, University of Colorado Cancer Center, 80045 - Aurora/US
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Abstract 1205P

Background

Next-generation targeted therapies for anaplastic lymphoma kinase-positive (ALK+) non-small cell lung cancer are associated with improved clinical outcomes, however, tumors develop resistance thus requiring subsequent therapies. Limited data are available on ALK TKI sequencing. The aim of our study was to understand duration of post-brigatinib ALK TKI therapy in the real-world setting.

Methods

Adults with ≥ 1 claim for brigatinib (index date; ID) between 01-Apr-2017 and 30-Sep-2020 were identified in IQVIA’s Pharmacy Claims Database. Patients had ≥ 12 months of data pre-ID and were followed until the end of available data. Kaplan-Meier methods estimated time to treatment discontinuation (TTD) for brigatinib and the subsequent ALK TKI.

Results

413 brigatinib patients were included (median age: 57.9 years; 58.4% female; median follow-up 8.4 months). Prior to initiating brigatinib, 195 patients had front-line crizotinib with or without subsequent ALK TKIs, 133 had crizotinib followed by alectinib and/or ceritinib, 62 had only crizotinib, 99 had only alectinib, and 80 had no observed ALK TKI. 167 (40.4%) brigatinib patients discontinued or switched to another ALK TKI. Median (95% confidence interval [CI]) brigatinib TTD was 10.3 (8.2-15.0) months. Among patients who discontinued brigatinib, 100 (59.9%) received subsequent ALK-TKIs. Lorlatinib was the most common next ALK TKI (57.0%), followed by brigatinib retreatment (16.0%), alectinib (13.0%), ceritinib (10.0%), and crizotinib (4.0%). The median (95% CI) TTD of the post-brigatinib ALK TKI was 7.2 (3.9-13.8) months. In patients who received crizotinib then brigatinib, the median (95% CI) TTD of the post-brigatinib ALK TKI was 6.7 (3.7-22.2) months. In patients who received lorlatinib after brigatinib was discontinued, median (95% CI) lorlartinib TTD was 8.0 (3.9-not reached) months.

Conclusions

These results indicate that brigatinib has real-world durable clinical effects for patients. Treatment with subsequent TKIs, can still bring benefit to patients after discontinuing brigatinib. More formalized prospective data are needed to establish sequencing recommendations.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

IQVIA.

Funding

Takeda.

Disclosure

M.O. Jahanzeb: Financial Interests, Personal and Institutional, Research Grant: Eli Lilly; Financial Interests, Personal and Institutional, Research Grant: Boehringer Ingelheim; Financial Interests, Personal and Institutional, Research Grant: Callisto; Financial Interests, Personal and Institutional, Research Grant: Takeda; Financial Interests, Personal, Invited Speaker: Novartis; Financial Interests, Personal, Invited Speaker: Roche/Genentech; Financial Interests, Personal, Invited Speaker: Pfizer; Financial Interests, Personal, Invited Speaker: Takeda; Financial Interests, Personal, Invited Speaker: Puma; Financial Interests, Personal, Invited Speaker: BMS; Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Invited Speaker: Merck. H.M. Lin: Financial Interests, Personal, Full or part-time Employment: Takeda; Financial Interests, Personal, Stocks/Shares: Takeda. Y. Wu: Financial Interests, Personal, Full or part-time Employment: Takeda; Financial Interests, Personal, Stocks/Shares: Takeda. M. Gorritz: Financial Interests, Personal, Full or part-time Employment: IQVIA. C.B. McGuiness: Financial Interests, Personal, Full or part-time Employment: IQVIA; Financial Interests, Personal, Stocks/Shares: Pfizer. K. Sun: Financial Interests, Personal, Full or part-time Employment: IQVIA. C. Chen: Financial Interests, Institutional, Full or part-time Employment: IQVIA. P. Zhang: Financial Interests, Personal, Full or part-time Employment: Takeda. D.R. Camidge: Financial Interests, Personal, Other, Honoraria: AstraZeneca; Financial Interests, Personal, Other, Honoraria: Takeda; Financial Interests, Personal, Other, Honoraria: Arrys/Kyn; Financial Interests, Personal, Other, Honoraria: Genoptix; Financial Interests, Personal, Other, Honoraria: G1 Therapeutics (DSMB); Financial Interests, Personal, Other, Honoraria: Mersana Therapeutics; Financial Interests, Personal, Other, Honoraria: Roche/Genentech; Financial Interests, Personal, Other, Honoraria: Ignyta; Financial Interests, Personal, Other, Honoraria: Daiichi Sankyo; Financial Interests, Personal, Other, Honoraria: Hansoh SRC; Financial Interests, Personal, Other, Honoraria: Bio-Thera DSMB; Financial Interests, Personal, Other, Honoraria: Lycera; Financial Interests, Personal, Other, Honoraria: Revolution Med; Financial Interests, Personal, Other, Honoraria: Orion; Financial Interests, Personal, Other, Honoraria: Clovis; Financial Interests, Personal, Other, Honoraria: Celgene; Financial Interests, Personal, Other, Honoraria: Novartis; Financial Interests, Personal and Institutional, Research Grant: ARIAD/Takeda.

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