Real-World Treatment Patterns, Survival, and Prediction of CNS Progression in ALK-Positive Non-Small-Cell Lung Cancer Patients Treated with First-Line Crizotinib in Latin America Oncology Practices.

Abstract

OBJECTIVE:

This study describes the real-world characteristics, treatment sequencing, and outcomes among Hispanic patients with locally advanced/metastatic ALK-positive non-small-cell lung cancer (NSCLC) treated with crizotinib.

METHODS:

A retrospective patient review was conducted for several centers in Latin America. Clinicians identified ALK-positive NSCLC patients who received crizotinib and reported their clinical characteristics, treatments, and survival. Overall survival and progression-free survival (PFS) were described. A Random Forest Tree (RFT) model was constructed to predict brain progression.

RESULTS:

A total of 73 patients were included; median age at diagnosis was 58 years, 60.3% were female, and 93.2% had adenocarcinoma. Eighty-nine percent of patients were never smokers/former smokers, 71.1% had ≥2 sites of metastasis, and 20.5% had brain metastases at diagnosis. The median PFS on first-line crizotinib was 7.07 months (95% CI 3.77-12.37) and the overall response rate was 52%. Of those who discontinued crizotinib, 55.9% progressed in the central nervous system (CNS). The RFT model reached a sensitivity of 100% and a specificity of 88% for prediction of CNS progression.

CONCLUSIONS:

The overall response rate and the PFS observed in Hispanic patients with ALK-positive NSCLC treated with first-line crizotinib were similar to those in previous reports. An RFT model is helpful in predicting CNS progression and can help clinicians tailor treatments in a resource-limited practice.

• Authors: Claudio Martín, Andrés F Cardona, Zyanya Lucia Zatarain-Barrón, Alejandro Ruiz-Patiño, Omar Castillo, George Oblitas, Luis Corrales, Lorena Lupinacci, María Angelina Pérez, Leonardo Rojas, Lisde González, Luis Chirinos, Carlos Ortíz, Mauricio Lema, Carlos Vargas, Carmen Puparelli, Hernán Carranza, Jorge Otero, Oscar Arrieta
• Journal: Oncology (Oncology) Vol. 94 Issue 5 Pg. 297-305 ( 2018) ISSN: 1423-0232 [Electronic] Switzerland
• PMID: 29510386 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2018 S. Karger AG, Basel.

Chemical References

• Protein Kinase Inhibitors
• Pyrazoles
• Pyridines
• Crizotinib
• ALK protein, human
• Anaplastic Lymphoma Kinase
• Receptor Protein-Tyrosine Kinases

Topics

• Adult
• Aged
• Aged, 80 and over
• Anaplastic Lymphoma Kinase
• Carcinoma, Non-Small-Cell Lung (drug therapy, mortality, physiopathology)
• Crizotinib
• Disease Progression
• Disease-Free Survival
• Female
• Follow-Up Studies
• Humans
• Latin America
• Lung Neoplasms (drug therapy, mortality, physiopathology)
• Male
• Middle Aged
• Protein Kinase Inhibitors (therapeutic use)
• Pyrazoles (therapeutic use)
• Pyridines (therapeutic use)
• Receptor Protein-Tyrosine Kinases (metabolism)
• Retrospective Studies