PMID- 34277814
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220830
IS  - 2305-5839 (Print)
IS  - 2305-5847 (Electronic)
IS  - 2305-5839 (Linking)
VI  - 9
IP  - 12
DP  - 2021 Jun
TI  - Outcomes of switching from crizotinib to alectinib in patients with advanced 
      non-small cell lung cancer with anaplastic lymphoma kinase fusion.
PG  - 1014
LID - 10.21037/atm-21-2769 [doi]
LID - 1014
AB  - BACKGROUND: Alectinib and crizotinib have been approved as first-line therapies 
      for advanced non-small cell lung cancer (NSCLC) with anaplastic lymphoma kinase 
      (ALK) gene fusion. However, the therapeutic efficacy and side effects are still 
      largely unknown of patients who switched to next-generation ALK tyrosine kinase 
      inhibitors (ALK-TKIs), such as alectinib, after experiencing no disease 
      progression with initial crizotinib treatment. METHODS: This prospective 
      real-world study enrolled patients who were treated with alectinib after 
      experiencing no disease progression with initial crizotinib treatment. The 
      patients' baseline characteristics, objective response rate (ORR) of crizotinib 
      and alectinib, size change of target tumor lesions, treatment regimen and adverse 
      events (AEs) were collected and analyzed. RESULTS: The study included 53 
      patients, the majority of whom (96.2%) had non-squamous NSCLC. The median age was 
      51 (range, 31-80) years old. The ORR of first-line crizotinib was 54.7%. The ORR 
      of sequential alectinib was 73.6%, and 90.5% of patients showed further tumor 
      shrinkage after the alectinib treatment. The median progression-free survival was 
      not reached, and 90.5% of patients were still enrolled in the study at the last 
      follow-up. Among them, 34.0% of patients switched to alectinib treatment due to 
      the toxicity. Crizotinib was associated with a higher frequency of AEs of grades 
      3 and 4 than alectinib (15.1% vs. 0%). Neither group had any AEs resulting in 
      death. CONCLUSIONS: Switching to alectinib might be an option for patients who do 
      not experience disease progression with initial crizotinib therapy, and may 
      promote better treatment compliance.
CI  - 2021 Annals of Translational Medicine. All rights reserved.
FAU - Pan, Yingying
AU  - Pan Y
AD  - Department of Medical Oncology, Shanghai Pulmonary Hospital &Thoracic Cancer 
      Institute, Tongji University School of Medicine, Shanghai, China.
FAU - Xiao, Wenjing
AU  - Xiao W
AD  - Department of Tumor Radiotherapy, The Affiliated Hospital of Qingdao University, 
      Qingdao, China.
FAU - Ye, Feng
AU  - Ye F
AD  - Xiamen Key Laboratory of Antitumor Drug Transformation Research, The First 
      Affiliated Hospital of Xiamen University, Xiamen, China.
FAU - Wang, Huijuan
AU  - Wang H
AD  - Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou 
      University, Henan Cancer Hospital, Zhengzhou, China.
FAU - Shen, Yihong
AU  - Shen Y
AD  - Department of Respiratory Medicine, The First Affiliated Hospital, Zhejiang 
      University School of Medicine, Hangzhou, China.
FAU - Yu, Xinmin
AU  - Yu X
AD  - Department of Thoracic Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
FAU - Han, Xiao
AU  - Han X
AD  - Department of Internal Medicine-Oncology, Shandong Cancer Hospital and Institute, 
      Shandong First Medical University and Shandong Academy of Medical Sciences, 
      Jinan, China.
FAU - Chu, Qian
AU  - Chu Q
AD  - Department of Oncology, Tongji Hospital of Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, China.
FAU - Zhou, Caicun
AU  - Zhou C
AD  - Department of Medical Oncology, Shanghai Pulmonary Hospital &Thoracic Cancer 
      Institute, Tongji University School of Medicine, Shanghai, China.
FAU - Zhang, Zhihong
AU  - Zhang Z
AD  - Department of Respiratory Oncology, Anhui Provincial Cancer Hospital (The First 
      Affiliated Hospital of USTC West District), Hefei, China.
FAU - Ren, Shengxiang
AU  - Ren S
AD  - Department of Medical Oncology, Shanghai Pulmonary Hospital &Thoracic Cancer 
      Institute, Tongji University School of Medicine, Shanghai, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Ann Transl Med
JT  - Annals of translational medicine
JID - 101617978
PMC - PMC8267309
OTO - NOTNLM
OT  - ALK fusion
OT  - alectinib
OT  - crizotinib
OT  - non-small cell lung cancer (NSCLC)
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at https://dx.doi.org/10.21037/atm-21-2769). YP, CZ, SR report 
      that this work was supported by the National Natural Science Foundation of China 
      (No. 81772467 to SR, No. 81972167 to SR), Shanghai Shenkang Hospital Development 
      Center (No. SHDC12019133 to SR) and Shanghai Innovative Collaboration Project 
      (No. 2020CXJQ02 to CZ). The other authors have no conflicts of interest to 
      declare.
EDAT- 2021/07/20 06:00
MHDA- 2021/07/20 06:01
PMCR- 2021/06/01
CRDT- 2021/07/19 06:01
PHST- 2021/05/04 00:00 [received]
PHST- 2021/06/16 00:00 [accepted]
PHST- 2021/07/19 06:01 [entrez]
PHST- 2021/07/20 06:00 [pubmed]
PHST- 2021/07/20 06:01 [medline]
PHST- 2021/06/01 00:00 [pmc-release]
AID - atm-09-12-1014 [pii]
AID - 10.21037/atm-21-2769 [doi]
PST - ppublish
SO  - Ann Transl Med. 2021 Jun;9(12):1014. doi: 10.21037/atm-21-2769.