| Online-Ressource |
Verfasst von: | El Sayed, Mei [VerfasserIn]  |
| Bozorgmehr, Farastuk [VerfasserIn]  |
| Kazdal, Daniel [VerfasserIn]  |
| Volckmar, Anna-Lena [VerfasserIn]  |
| Sültmann, Holger [VerfasserIn]  |
| Fischer, Jürgen [VerfasserIn]  |
| Kriegsmann, Mark [VerfasserIn]  |
| Stenzinger, Albrecht [VerfasserIn]  |
| Thomas, Michael [VerfasserIn]  |
| Christopoulos, Petros [VerfasserIn]  |
Titel: | Feasibility and challenges for sequential treatments in ALK-rearranged non-small-cell lung cancer |
Verf.angabe: | Mei Elsayed, Farastuk Bozorgmehr, Daniel Kazdal, Anna-Lena Volckmar, Holger Sültmann, Jürgen R. Fischer, Mark Kriegsmann, Albrecht Stenzinger, Michael Thomas and Petros Christopoulos |
E-Jahr: | 2021 |
Jahr: | 20 April 2021 |
Umfang: | 8 S. |
Teil: | volume:11 |
| year:2021 |
| month:04 |
| elocationid:670483 |
| pages:1-8 |
| extent:8 |
Fussnoten: | Gesehen am 29.04.2021 |
Titel Quelle: | Enthalten in: Frontiers in oncology |
Ort Quelle: | Lausanne : Frontiers Media, 2011 |
Jahr Quelle: | 2021 |
Band/Heft Quelle: | 11(2021) vom: Apr., Artikel-ID 670483, Seite 1-8 |
ISSN Quelle: | 2234-943X |
Abstract: | Background: Anaplastic lymphoma kinase-rearranged non-small-cell lung cancer (ALK+ NSCLC) is a model disease for use of targeted therapies (TKI), which are administered sequentially to maximize patient survival. Methods: We retrospectively analyzed the flow of 145 consecutive TKI-treated ALK+ NSCLC patients across therapy lines. Suitable patients that could not receive an available next-line therapy ("attrition") were determined separately for various treatments, based on the approval status of the respective targeted drugs when each treatment failure occurred in each patient. Results: At the time of analysis, 70/144 (49%) evaluable patients were still alive. Attrition rates related to targeted treatments were approximately 25-30% and similar for administration of a second-generation (2G) ALK inhibitor (22%, 17/79) or any subsequent systemic therapy (27%, 27/96) after crizotinib, and for the administration of lorlatinib (27%, 6/22) or any subsequent systemic therapy (25%, 15/61) after any 2G TKI. The rate of chemotherapy implementation was 67% (62/93). Both administration of additional TKI (median overall survival [mOS] 59 vs. 41 months for multiple vs. one TKI lines, logrank p=0.002), and chemotherapy (mOS 41 vs. 16 months, logrank p<0.001) were significantly associated with longer survival. Main reason for patients foregoing any subsequent systemic treatment was rapid clinical deterioration (n=40/43 or 93%) caused by tumor progression. In 2/3 of cases (29/43), death occurred under the first failing therapy, while in 11/43 the treatment was switched, but the patient did not respond, deteriorated further, and died within 8 weeks. Conclusions: Despite absence of regulatory obstacles and no requirement for specific acquired mutations, 25-30% of ALK+ NSCLC patients forego subsequent systemic therapy due to rapid clinical deterioration, in several cases (approximately 1/3) associated with an ineffective first next-line choice. These results underline the need for closer patient monitoring and broader profiling in order to support earlier and better directed use of available therapies. |
DOI: | doi:10.3389/fonc.2021.670483 |
URL: | Kostenfrei: Volltext ; Verlag: https://doi.org/10.3389/fonc.2021.670483 |
| Kostenfrei: Volltext: https://www.frontiersin.org/articles/10.3389/fonc.2021.670483/full |
| DOI: https://doi.org/10.3389/fonc.2021.670483 |
Datenträger: | Online-Ressource |
Sprache: | eng |
Sach-SW: | ALK-rearranged non-small-cell lung cancer |
| chemotherapy |
| overall survival |
| Sequential therapies |
| tyrosine kinase inhibitors |
K10plus-PPN: | 1756579016 |
Verknüpfungen: | → Zeitschrift |
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Lokale URL UB: | Zum Volltext |
Feasibility and challenges for sequential treatments in ALK-rearranged non-small-cell lung cancer / El Sayed, Mei [VerfasserIn]; 20 April 2021 (Online-Ressource)