PMID- 38213541
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240113
IS  - 2692-3114 (Electronic)
IS  - 2692-3114 (Linking)
VI  - 4
IP  - 6
DP  - 2023
TI  - Comparing efficacy and safety of upfront treatment strategies for anaplastic 
      lymphoma kinase-positive non-small cell lung cancer: a network meta-analysis.
PG  - 1136-1144
LID - 10.37349/etat.2023.00187 [doi]
AB  - AIM: This article is based on our previous research, which was presented as a 
      post at the Congress Aiom 2022 Congress and published in Tumori Journal as 
      Conference Abstract (Tumori J. 2022;108:1-194. doi: 10.1177/03008916221114500). 
      In this paper, a comprehensive presentation of all the achieved results is 
      provided. Several tyrosine kinase inhibitors (TKIs) have been investigated to 
      treat patients with anaplastic lymphoma kinase (ALK)-positive non-small cell lung 
      cancer (NSCLC). However, direct comparisons between these TKIs are lacking, with 
      many only being compared to crizotinib. To address this gap, a network 
      meta-analysis was conducted to compare the efficacy and safety of various 
      first-line systemic therapies for ALK-positive NSCLC. METHODS: A thorough search 
      of PubMed, Embase, and Cochrane Library was performed to identify randomized 
      controlled trials (RCTs) published between January 01, 2000 and April 01, 2022, 
      and included trials that investigated upfront treatments for this molecular 
      subgroup and reported overall survival (OS), progression-free survival (PFS), 
      objective response rate (ORR), and adverse events (AEs) of grade 3 or higher 
      (grade >/= 3 AEs). RESULTS: The analysis included 9 RCTs with 2,443 patients 
      receiving eight different treatments: alectinib (at two different dosages), 
      brigatinib, ceritinib, crizotinib, ensartinib, lorlatinib, and chemotherapy. 
      Second and third-generation TKIs significantly prolonged PFS compared to 
      crizotinib, with lorlatinib having the highest probability of yielding the most 
      favorable PFS, followed by alectinib (300 mg or 600 mg). However, only alectinib 
      has been shown to significantly prolong OS compared to crizotinib to date. 
      Lorlatinib appears superior in reducing the risk of central nervous system (CNS) 
      progression, followed by alectinib 600 mg. Ceritinib had the highest rate of AEs, 
      followed by lorlatinib and brigatinib. CONCLUSIONS: Based on the network 
      meta-analysis, alectinib and lorlatinib emerged as the most promising upfront 
      treatment options. These treatments provide prolonged disease control while 
      maintaining an acceptable safety profile.
CI  - (c) The Author(s) 2023.
FAU - Filetti, Marco
AU  - Filetti M
AUID- ORCID: 0000-0002-4734-7541
AD  - Phase 1 Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, 
      Italy.
AD  - Department of Experimental Medicine, Sapienza University of Rome, 00168 Rome, 
      Italy.
FAU - Lombardi, Pasquale
AU  - Lombardi P
AUID- ORCID: 0000-0001-6262-2161
AD  - Phase 1 Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, 
      Italy.
FAU - Falcone, Rosa
AU  - Falcone R
AD  - Phase 1 Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, 
      Italy.
FAU - Giusti, Raffaele
AU  - Giusti R
AD  - Medical Oncology Unit, Sant'Andrea Hospital of Rome, 00168 Rome, Italy.
FAU - Giannarelli, Diana
AU  - Giannarelli D
AD  - Biostatistics Unit, Scientific Directorate, Fondazione Policlinico Universitario 
      A. Gemelli IRCCS, 00168 Rome, Italy.
FAU - Carcagni, Antonella
AU  - Carcagni A
AD  - Biostatistics Unit, Scientific Directorate, Fondazione Policlinico Universitario 
      A. Gemelli IRCCS, 00168 Rome, Italy.
FAU - Altamura, Valeria
AU  - Altamura V
AD  - Phase 1 Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, 
      Italy.
FAU - Scambia, Giovanni
AU  - Scambia G
AD  - Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli IRCCS, 
      00168 Rome, Italy.
AD  - Department of Life Science and Public Health, Universita Cattolica del Sacro 
      Cuore, 00168 Rome, Italy.
FAU - Daniele, Gennaro
AU  - Daniele G
AUID- ORCID: 0000-0001-5360-1895
AD  - Phase 1 Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, 
      Italy.
LA  - eng
PT  - Systematic Review
DEP - 20231201
PL  - United States
TA  - Explor Target Antitumor Ther
JT  - Exploration of targeted anti-tumor therapy
JID - 101770662
PMC - PMC10784113
OTO - NOTNLM
OT  - Non-small cell lung cancer
OT  - anaplastic lymphoma kinase translocations
OT  - targeted therapy
COIS- Raffaele Giusti declared financial interests with Roche (expert testimony, 
      personal, advisory board for clinician's expertise on drug management); Molteni 
      (writing engagement, personal, publication fee for open access manuscript); 
      Novartis (advisory board, personal); Angelini Pharma (invited speaker, personal, 
      invited speaker to national and international congress); Pfizer (advisory board, 
      personal) and Takeda (expert testimony, personal, expert testimony on drug 
      management). Giovanni Scambia has served as consultant for TESARO Bio Italy S.r.l 
      and Johnson & Johnson. He received onoraria from Clovis Oncology Italy S.r.l, and 
      institutional research funding from MSD Italy S.r.l. Gennaro Daniele has served 
      on advisory board of Beigene and received support for travel and accomodation 
      from Roche. The other authors declare that they have no conflict of interest.
EDAT- 2024/01/12 06:43
MHDA- 2024/01/12 06:44
PMCR- 2023/12/01
CRDT- 2024/01/12 03:41
PHST- 2023/02/07 00:00 [received]
PHST- 2023/03/23 00:00 [accepted]
PHST- 2024/01/12 06:44 [medline]
PHST- 2024/01/12 06:43 [pubmed]
PHST- 2024/01/12 03:41 [entrez]
PHST- 2023/12/01 00:00 [pmc-release]
AID - 10.37349/etat.2023.00187 [doi]
PST - ppublish
SO  - Explor Target Antitumor Ther. 2023;4(6):1136-1144. doi: 10.37349/etat.2023.00187. 
      Epub 2023 Dec 1.