Abstract 164P
Background
Postoperative oral alectinib adjuvant treatment for 2 years has become the standard treatment modality for patients with stage IBIIIA lung cancer undergoing surgery with ALK rearrangement. However, studies on the role of neoadjuvant treatment with alectinib are lacking. This study investigated the efficacy and safety of neoadjuvant treatment with alectinib through a two-center retrospective cohort analysis.
Methods
ALK-positive lung adenocarcinoma patients treated with neoadjuvant alectinib from two hospitals in China between February 2019 and November 2023 were included. Data on clinical features, clinical and pathological responses, survival follow-up, and safety were collected and evaluated.
Results
Nine patients with stage IIB-IIIB lung adenocarcinoma who received neoadjuvant alectinib therapy were analyzed. Of these patients, six were males and three were females aged from 37 to 74 (median age of 51). Most patients (77.8%) had stage IIIA to IIIB disease. The duration of neoadjuvant alectinib treatment ranged from 2 months to 9 months. All cases showed a partial response in the preoperative clinical imaging evaluation, and postoperative pathology indicated that all patients underwent R0 resection. Moreover, the major pathological response (MPR) rate was 55.6% (5/9), with 33.3% (3/9) achieving a pathological complete response (pCR). All patients continued to receive adjuvant alectinib treatment after surgery, and as of May 2024, EFS has ranged from 14 to 62 months, with no patients experiencing recurrence, metastasis, or death. All patients treated with alectinib in the perioperative period experienced grade 1–2 treatment-related adverse events, with no adverse events greater than or equal to grade 3.
Conclusions
We retrospectively analyzed patients receiving neoadjuvant treatment with alectinib in two centers. Neoadjuvant alectinib therapy achieved acceptable clinical and pathological outcomes and excellent surgical tolerability and safety, suggesting that preoperative neoadjuvant alectinib therapy is feasible. Future large clinical trials are needed to evaluate the safety and efficacy of neoadjuvant alectinib treatment.
Legal entity responsible for the study
Beijing Chest Hospital, Capital Medical University.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.