PMID- 34915469
OWN - NLM
STAT- MEDLINE
DCOM- 20220525
LR  - 20220602
IS  - 1421-9794 (Electronic)
IS  - 0009-3157 (Linking)
VI  - 67
IP  - 2
DP  - 2022
TI  - Crizotinib versus Alectinib for the Treatment of ALK-Positive Non-Small Cell Lung 
      Cancer: A Systematic Review and Meta-Analysis.
PG  - 67-80
LID - 10.1159/000521452 [doi]
AB  - BACKGROUND: Crizotinib and alectinib are the 2 most commonly used anaplastic 
      lymphoma kinase (ALK) inhibitors for ALK-positive non-small cell lung cancer 
      (NSCLC). We compared their antitumor efficacies and adverse effects based on a 
      pooled analysis of the ALEX, ALESIA, and J-ALEX clinical trials. METHODS: Seven 
      databases were searched for eligible articles. The primary endpoints included 
      overall survival (OS), progression-free survival (PFS), central nervous system 
      (CNS)-PFS, drug responses, and adverse effects (AEs). RESULTS: Seven articles on 
      3 randomized controlled clinical trials (ALEX, ALESIA, and J-ALEX) that included 
      697 patients were included. Compared with crizotinib, alectinib exhibited 
      superior efficacy in PFS (HR [hazard ratio]: 0.35 [0.25-0.49], p < 0.00001), OS 
      (HR: 0.66 [0.47-0.92], p = 0.02), CNS-PFS (HR: 0.17 [0.11-0.24], p < 0.00001), 
      duration of response (HR: 0.31 [0.23-0.42], p < 0.00001), objective response rate 
      (risk ratio [RR]: 0.87 [0.80-0.94], p = 0.0003), partial response (RR: 0.88 
      [0.81-0.96], p = 0.004), and grade 3-5 AEs (RR: 1.43 [1.09-1.87], p = 0.009). 
      Additionally, compared with crizotinib, alectinib exhibited a survival advantage 
      that increased with its prolongation of survival time. The disease control rate, 
      complete response, and total AEs were comparable between the 2 groups. The 
      crizotinib group reported higher rates of constipation, nausea, diarrhea, 
      vomiting, peripheral edema, dysgeusia, visual impairment, and levels of alanine 
      aminotransferase and aspartate aminotransferase as well as greater decreases in 
      appetite and neutrophil count. CONCLUSIONS: In both antitumor efficacy and 
      safety, alectinib appears to be superior to crizotinib for the treatment of 
      ALK-positive NSCLC.
CI  - (c) 2021 S. Karger AG, Basel.
FAU - Zeng, Qinghua
AU  - Zeng Q
AD  - Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital 
      of Nanchang University, Nanchang, China.
FAU - Zhang, Xiquan
AU  - Zhang X
AD  - Department of Oncology, Jiangxi Provincial People's Hospital, Nanchang, China.
FAU - He, Shan
AU  - He S
AD  - Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital 
      of Nanchang University, Nanchang, China.
FAU - Zhou, Zhiyong
AU  - Zhou Z
AD  - Department of Oncology, Jiangxi Provincial People's Hospital, Nanchang, China.
FAU - Xia, Luping
AU  - Xia L
AD  - Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital 
      of Nanchang University, Nanchang, China.
FAU - Zhang, Wenxiong
AU  - Zhang W
AD  - Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, China.
FAU - Zeng, Lin
AU  - Zeng L
AD  - Department of Oncology, Jiangxi Provincial People's Hospital, Nanchang, China.
LA  - eng
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20211214
PL  - Switzerland
TA  - Chemotherapy
JT  - Chemotherapy
JID - 0144731
RN  - 0 (Carbazoles)
RN  - 0 (Piperidines)
RN  - 0 (Protein Kinase Inhibitors)
RN  - 53AH36668S (Crizotinib)
RN  - EC 2.7.10.1 (Anaplastic Lymphoma Kinase)
RN  - LIJ4CT1Z3Y (alectinib)
SB  - IM
MH  - Anaplastic Lymphoma Kinase
MH  - Carbazoles
MH  - *Carcinoma, Non-Small-Cell Lung
MH  - Crizotinib/adverse effects
MH  - Humans
MH  - *Lung Neoplasms
MH  - Piperidines
MH  - Protein Kinase Inhibitors/adverse effects
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - Alectinib
OT  - Anaplastic lymphoma kinase
OT  - Crizotinib
OT  - Meta-analysis
OT  - Non-small cell lung cancer
EDAT- 2021/12/17 06:00
MHDA- 2022/05/26 06:00
CRDT- 2021/12/16 20:35
PHST- 2021/09/22 00:00 [received]
PHST- 2021/12/10 00:00 [accepted]
PHST- 2021/12/17 06:00 [pubmed]
PHST- 2022/05/26 06:00 [medline]
PHST- 2021/12/16 20:35 [entrez]
AID - 000521452 [pii]
AID - 10.1159/000521452 [doi]
PST - ppublish
SO  - Chemotherapy. 2022;67(2):67-80. doi: 10.1159/000521452. Epub 2021 Dec 14.