PMID- 30230699
OWN - NLM
STAT- MEDLINE
DCOM- 20191107
LR  - 20240402
IS  - 2045-7634 (Electronic)
IS  - 2045-7634 (Linking)
VI  - 7
IP  - 10
DP  - 2018 Oct
TI  - The efficacy and safety of ALK inhibitors in the treatment of ALK-positive 
      non-small cell lung cancer: A network meta-analysis.
PG  - 4993-5005
LID - 10.1002/cam4.1768 [doi]
AB  - PURPOSE: The current study was carried out to compare the effectiveness and 
      safety of different ALK inhibitors in treating ALK+ NSCLC. METHODS: 
      Progression-free survival (PFS), disease control rate (DCR), overall response 
      rate (ORR), and intracranial ORR and DCR have been aggregated to appraise the 
      effectiveness of each ALKi. The discontinuation rate due to adverse events (AEs) 
      was pooled to evaluate their safety. Bayesian network meta-analyses were used to 
      compare the ORR, DCR, PFS, and discontinuation rate of patients treated with 
      alectinib, ceritinib, crizotinib, and chemotherapy. RESULTS: Compared with 
      chemotherapy, ALK inhibitors significantly prolonged PFS [hazard ratio (HR) and 
      95% confidence interval (CI): alectinib, 0.50 (0.43-0.58); ceritinib, 0.75 
      (0.69-0.83); crizotinib, 0.71 (0.66-0.76)]. The ORRs were significantly higher 
      for ALK inhibitors than for chemotherapy [odds ratio (OR) and corresponding 95% 
      CI: alectinib, 11.69 (4.29-36.56); ceritinib, 7.85 (3.44-19.27); crizotinib, 6.04 
      (3.33-11.71)]. The discontinuation rates were lower for ALK inhibitors than for 
      chemotherapy [OR and corresponding 95% CI: alectinib, 0.42 (0.12-1.36); 
      ceritinib, 0.52 (0.20-1.35); crizotinib, 0.70 (0.30-1.62)]. CONCLUSIONS: ALK+ 
      NSCLC patients treated with ALKi tend to have longer PFS than those treated with 
      chemotherapy. ALKi-naive patients tended to response better than their 
      ALKi-pretreated counterparts. Alectinib appeared to be preferable for treating 
      brain metastases due to its high intracranial efficacy. Patients treated with 
      alectinib or ceritinib tended to have higher ORR and DCR than patients with 
      similar baselines treated with crizotinib or chemotherapy. No significant 
      differences in discontinuation rate were found for alectinib, ceritinib, 
      crizotinib, and chemotherapy.
CI  - (c) 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
FAU - Fan, Junsheng
AU  - Fan J
AUID- ORCID: 0000-0002-5143-2968
AD  - Department of Oncology, Zhujiang Hospital of Southern Medical University, 
      Guangzhou, China.
AD  - Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji 
      University, Shanghai, China.
FAU - Fong, Tszhei
AU  - Fong T
AD  - Department of Oncology, Zhujiang Hospital of Southern Medical University, 
      Guangzhou, China.
FAU - Xia, Zengfei
AU  - Xia Z
AD  - Department of Oncology, Zhujiang Hospital of Southern Medical University, 
      Guangzhou, China.
FAU - Zhang, Jian
AU  - Zhang J
AUID- ORCID: 0000-0001-7217-0111
AD  - Department of Oncology, Zhujiang Hospital of Southern Medical University, 
      Guangzhou, China.
FAU - Luo, Peng
AU  - Luo P
AUID- ORCID: 0000-0002-8215-2045
AD  - Department of Oncology, Zhujiang Hospital of Southern Medical University, 
      Guangzhou, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180919
PL  - United States
TA  - Cancer Med
JT  - Cancer medicine
JID - 101595310
RN  - 0 (Carbazoles)
RN  - 0 (Piperidines)
RN  - 0 (Protein Kinase Inhibitors)
RN  - 0 (Pyrimidines)
RN  - 0 (Sulfones)
RN  - 53AH36668S (Crizotinib)
RN  - EC 2.7.10.1 (ALK protein, human)
RN  - EC 2.7.10.1 (Anaplastic Lymphoma Kinase)
RN  - K418KG2GET (ceritinib)
RN  - LIJ4CT1Z3Y (alectinib)
SB  - IM
MH  - Anaplastic Lymphoma Kinase/*genetics
MH  - Bayes Theorem
MH  - Carbazoles/therapeutic use
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy/genetics
MH  - Crizotinib/therapeutic use
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/*drug therapy/genetics
MH  - Male
MH  - Middle Aged
MH  - Network Meta-Analysis
MH  - Piperidines/therapeutic use
MH  - Protein Kinase Inhibitors/*therapeutic use
MH  - Pyrimidines/therapeutic use
MH  - Sulfones/therapeutic use
MH  - Survival Analysis
MH  - Treatment Outcome
PMC - PMC6198244
OTO - NOTNLM
OT  - anaplastic lymphoma kinase inhibitor (ALKi)
OT  - brain metastasis
OT  - network meta-analysis
OT  - non-small cell lung cancer (NSCLC)
EDAT- 2018/09/20 06:00
MHDA- 2019/11/08 06:00
PMCR- 2018/09/19
CRDT- 2018/09/20 06:00
PHST- 2018/05/18 00:00 [received]
PHST- 2018/07/14 00:00 [revised]
PHST- 2018/08/19 00:00 [accepted]
PHST- 2018/09/20 06:00 [pubmed]
PHST- 2019/11/08 06:00 [medline]
PHST- 2018/09/20 06:00 [entrez]
PHST- 2018/09/19 00:00 [pmc-release]
AID - CAM41768 [pii]
AID - 10.1002/cam4.1768 [doi]
PST - ppublish
SO  - Cancer Med. 2018 Oct;7(10):4993-5005. doi: 10.1002/cam4.1768. Epub 2018 Sep 19.