Trends in Real-World Clinical Outcomes of Patients with Anaplastic Lymphoma Kinase (ALK) Rearranged Non-Small Cell Lung Cancer (NSCLC) Receiving One or More ALK Tyrosine Kinase Inhibitors (TKIs): A Cohort Study in Ontario, Canada
The treatment landscape for patients with advanced ALK-positive NSCLC has rapidly evolved following the approval of several ALK TKIs in Canada. However, public funding of ALK TKIs is mostly limited to the first line treatment setting. Using linked provincial health administrative databases, we exami...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-12-01
|
| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/32/1/13 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832588697741033472 |
|---|---|
| author | Lara Chayab Natasha B. Leighl Mina Tadrous Christine M. Warren William W. L. Wong |
| author_facet | Lara Chayab Natasha B. Leighl Mina Tadrous Christine M. Warren William W. L. Wong |
| author_sort | Lara Chayab |
| collection | DOAJ |
| description | The treatment landscape for patients with advanced ALK-positive NSCLC has rapidly evolved following the approval of several ALK TKIs in Canada. However, public funding of ALK TKIs is mostly limited to the first line treatment setting. Using linked provincial health administrative databases, we examined real-world outcomes of patients with advanced ALK-positive NSCLC receiving ALK TKIs in Ontario between 1 January 2012 and 31 December 2021. Demographic, clinical characteristics and treatment patterns were summarized using descriptive statistics. Kaplan–Meier analysis was performed to evaluate progression-free survival (PFS) and overall survival (OS) among the treatment groups. A total of 413 patients were identified. Patients were administered alectinib (n = 154), crizotinib (n = 80), or palliative-intent chemotherapy (n = 55) in the first-line treatment. There was a significant difference in first-line PFS between the treatment groups. The median PFS (mPFS) was not reached for alectinib (95% CI, 568 days—not reached), compared to 8.2 months (95% CI, 171–294 days) for crizotinib (HR = 0.34, <i>p</i> < 0.0001) and 2.4 months (95% CI, 65–100 days) for chemotherapy (HR = 0.14, <i>p</i> < 0.0001). There was no significant difference in first-line OS between the treatment groups. In patients who received more than one line of treatment, there was a significant difference in mOS between patients who received two or more lines of ALK TKIs compared to those who received one line of ALK TKI (mOS = 55 months (95% CI, 400–987 days) and 26 months (95% CI, 1448–2644 days), respectively, HR = 4.64, <i>p</i> < 0.0001). This study confirms the effectiveness of ALK TKIs in real-world practice and supports the potential benefit of multiple lines of ALK TKI on overall survival in patients with ALK-positive NSCLC. |
| format | Article |
| id | doaj-art-5cfe2bc54a3e46d7939ab441502b834e |
| institution | Kabale University |
| issn | 1198-0052 1718-7729 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj-art-5cfe2bc54a3e46d7939ab441502b834e2025-01-24T13:28:21ZengMDPI AGCurrent Oncology1198-00521718-77292024-12-013211310.3390/curroncol32010013Trends in Real-World Clinical Outcomes of Patients with Anaplastic Lymphoma Kinase (ALK) Rearranged Non-Small Cell Lung Cancer (NSCLC) Receiving One or More ALK Tyrosine Kinase Inhibitors (TKIs): A Cohort Study in Ontario, CanadaLara Chayab0Natasha B. Leighl1Mina Tadrous2Christine M. Warren3William W. L. Wong4Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, CanadaPrincess Margaret Cancer Centre, Toronto, ON M5G 2M9, CanadaLeslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, CanadaICES, Toronto, ON M4N 3M5, CanadaSchool of Pharmacy, University of Waterloo, Waterloo, ON N2L 3G1, CanadaThe treatment landscape for patients with advanced ALK-positive NSCLC has rapidly evolved following the approval of several ALK TKIs in Canada. However, public funding of ALK TKIs is mostly limited to the first line treatment setting. Using linked provincial health administrative databases, we examined real-world outcomes of patients with advanced ALK-positive NSCLC receiving ALK TKIs in Ontario between 1 January 2012 and 31 December 2021. Demographic, clinical characteristics and treatment patterns were summarized using descriptive statistics. Kaplan–Meier analysis was performed to evaluate progression-free survival (PFS) and overall survival (OS) among the treatment groups. A total of 413 patients were identified. Patients were administered alectinib (n = 154), crizotinib (n = 80), or palliative-intent chemotherapy (n = 55) in the first-line treatment. There was a significant difference in first-line PFS between the treatment groups. The median PFS (mPFS) was not reached for alectinib (95% CI, 568 days—not reached), compared to 8.2 months (95% CI, 171–294 days) for crizotinib (HR = 0.34, <i>p</i> < 0.0001) and 2.4 months (95% CI, 65–100 days) for chemotherapy (HR = 0.14, <i>p</i> < 0.0001). There was no significant difference in first-line OS between the treatment groups. In patients who received more than one line of treatment, there was a significant difference in mOS between patients who received two or more lines of ALK TKIs compared to those who received one line of ALK TKI (mOS = 55 months (95% CI, 400–987 days) and 26 months (95% CI, 1448–2644 days), respectively, HR = 4.64, <i>p</i> < 0.0001). This study confirms the effectiveness of ALK TKIs in real-world practice and supports the potential benefit of multiple lines of ALK TKI on overall survival in patients with ALK-positive NSCLC.https://www.mdpi.com/1718-7729/32/1/13ALK inhibitorsALK TKIsNSCLClung cancerreal-world outcomesalectinib |
| spellingShingle | Lara Chayab Natasha B. Leighl Mina Tadrous Christine M. Warren William W. L. Wong Trends in Real-World Clinical Outcomes of Patients with Anaplastic Lymphoma Kinase (ALK) Rearranged Non-Small Cell Lung Cancer (NSCLC) Receiving One or More ALK Tyrosine Kinase Inhibitors (TKIs): A Cohort Study in Ontario, Canada Current Oncology ALK inhibitors ALK TKIs NSCLC lung cancer real-world outcomes alectinib |
| title | Trends in Real-World Clinical Outcomes of Patients with Anaplastic Lymphoma Kinase (ALK) Rearranged Non-Small Cell Lung Cancer (NSCLC) Receiving One or More ALK Tyrosine Kinase Inhibitors (TKIs): A Cohort Study in Ontario, Canada |
| title_full | Trends in Real-World Clinical Outcomes of Patients with Anaplastic Lymphoma Kinase (ALK) Rearranged Non-Small Cell Lung Cancer (NSCLC) Receiving One or More ALK Tyrosine Kinase Inhibitors (TKIs): A Cohort Study in Ontario, Canada |
| title_fullStr | Trends in Real-World Clinical Outcomes of Patients with Anaplastic Lymphoma Kinase (ALK) Rearranged Non-Small Cell Lung Cancer (NSCLC) Receiving One or More ALK Tyrosine Kinase Inhibitors (TKIs): A Cohort Study in Ontario, Canada |
| title_full_unstemmed | Trends in Real-World Clinical Outcomes of Patients with Anaplastic Lymphoma Kinase (ALK) Rearranged Non-Small Cell Lung Cancer (NSCLC) Receiving One or More ALK Tyrosine Kinase Inhibitors (TKIs): A Cohort Study in Ontario, Canada |
| title_short | Trends in Real-World Clinical Outcomes of Patients with Anaplastic Lymphoma Kinase (ALK) Rearranged Non-Small Cell Lung Cancer (NSCLC) Receiving One or More ALK Tyrosine Kinase Inhibitors (TKIs): A Cohort Study in Ontario, Canada |
| title_sort | trends in real world clinical outcomes of patients with anaplastic lymphoma kinase alk rearranged non small cell lung cancer nsclc receiving one or more alk tyrosine kinase inhibitors tkis a cohort study in ontario canada |
| topic | ALK inhibitors ALK TKIs NSCLC lung cancer real-world outcomes alectinib |
| url | https://www.mdpi.com/1718-7729/32/1/13 |
| work_keys_str_mv | AT larachayab trendsinrealworldclinicaloutcomesofpatientswithanaplasticlymphomakinasealkrearrangednonsmallcelllungcancernsclcreceivingoneormorealktyrosinekinaseinhibitorstkisacohortstudyinontariocanada AT natashableighl trendsinrealworldclinicaloutcomesofpatientswithanaplasticlymphomakinasealkrearrangednonsmallcelllungcancernsclcreceivingoneormorealktyrosinekinaseinhibitorstkisacohortstudyinontariocanada AT minatadrous trendsinrealworldclinicaloutcomesofpatientswithanaplasticlymphomakinasealkrearrangednonsmallcelllungcancernsclcreceivingoneormorealktyrosinekinaseinhibitorstkisacohortstudyinontariocanada AT christinemwarren trendsinrealworldclinicaloutcomesofpatientswithanaplasticlymphomakinasealkrearrangednonsmallcelllungcancernsclcreceivingoneormorealktyrosinekinaseinhibitorstkisacohortstudyinontariocanada AT williamwlwong trendsinrealworldclinicaloutcomesofpatientswithanaplasticlymphomakinasealkrearrangednonsmallcelllungcancernsclcreceivingoneormorealktyrosinekinaseinhibitorstkisacohortstudyinontariocanada |