PMID- 38405000
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240227
IS  - 2218-6751 (Print)
IS  - 2226-4477 (Electronic)
IS  - 2218-6751 (Linking)
VI  - 13
IP  - 1
DP  - 2024 Jan 31
TI  - Alectinib continuation beyond progression in ALK-positive non-small cell lung 
      cancer with alectinib-refractory.
PG  - 152-162
LID - 10.21037/tlcr-23-798 [doi]
AB  - BACKGROUND: Alectinib, a next-generation anaplastic lymphoma kinase tyrosine 
      kinase inhibitor (ALK-TKI), has demonstrated noteworthy efficacy in the treatment 
      of non-small cell lung cancer (NSCLC). Unfortunately, 53.3% of untreated patients 
      receiving first-line treatment with alectinib developed resistance to alectinib. 
      However, despite the widespread use of alectinib, studies on the efficacy and 
      safety of continuing alectinib with other necessary therapies after progression 
      of alectinib and possible population of benefit are still limited. METHODS: This 
      retrospective cohort study included fifteen patients with ALK-positive NSCLC from 
      nine institutions in China who experienced disease progression after first- or 
      second-line treatment and continued to receive alectinib treatment between 2019 
      and 2022. This study aimed to evaluate the median progression-free survival 
      (mPFS), objective response rate (ORR), median overall survival (mOS), and adverse 
      events (AEs) of continuing alectinib combined with other therapies after the 
      emergence of drug resistance. RESULTS: Among fifteen patients eligible for this 
      study, all patients started continuing treatment with alectinib after 
      oligoprogression or central nervous system (CNS) progression. The mPFS for the 
      whole cohort receiving continuing alectinib with other necessary therapies was 8 
      months [95% confidence interval (CI): 4 to not applicable (NA)], with an ORR of 
      46.7%. The mOS was not reached. During continuing alectinib treatment, only one 
      patient experienced grade 2 elevation of aspartate aminotransferase (AST) and 
      serum glutamic-oxaloacetic transaminase (SGOT). CONCLUSIONS: The continuation of 
      alectinib treatment combined with other necessary therapies demonstrates 
      favorable response and safety in patients with ALK-positive NSCLC who experienced 
      oligoprogression or CNS progression following alectinib in first- or second-line 
      therapy. Instead of immediately switching to another ALK-TKI, continuing 
      alectinib combined with other necessary therapies may offer greater survival 
      benefits to the patients.
CI  - 2024 Translational Lung Cancer Research. All rights reserved.
FAU - Li, Yimeng
AU  - Li Y
AD  - Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an, China.
FAU - Hao, Zhanpeng
AU  - Hao Z
AD  - Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an, China.
FAU - Ma, Yuyan
AU  - Ma Y
AD  - Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an, China.
FAU - Setiwalidi, Kaidiriye
AU  - Setiwalidi K
AD  - Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an, China.
FAU - Zhang, Yingming
AU  - Zhang Y
AD  - Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an, China.
FAU - Zhao, Yujia
AU  - Zhao Y
AD  - Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an, China.
FAU - Fu, Xiao
AU  - Fu X
AD  - Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an, China.
FAU - Liang, Xuan
AU  - Liang X
AD  - Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an, China.
FAU - Ruan, Zhiping
AU  - Ruan Z
AD  - Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an, China.
FAU - Tian, Tao
AU  - Tian T
AD  - Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an, China.
FAU - Yao, Yu
AU  - Yao Y
AD  - Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an, China.
LA  - eng
PT  - Journal Article
DEP - 20240122
PL  - China
TA  - Transl Lung Cancer Res
JT  - Translational lung cancer research
JID - 101646875
PMC - PMC10891411
OTO - NOTNLM
OT  - ALK-positive
OT  - Alectinib
OT  - anaplastic lymphoma kinase-tyrosine kinase inhibitor (ALK-TKI)
OT  - non-small cell lung cancer (NSCLC)
OT  - resistance
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://tlcr.amegroups.com/article/view/10.21037/tlcr-23-798/coif). The authors 
      have no conflicts of interest to declare.
EDAT- 2024/02/26 06:45
MHDA- 2024/02/26 06:46
PMCR- 2024/01/31
CRDT- 2024/02/26 04:35
PHST- 2023/12/01 00:00 [received]
PHST- 2024/01/11 00:00 [accepted]
PHST- 2024/02/26 06:46 [medline]
PHST- 2024/02/26 06:45 [pubmed]
PHST- 2024/02/26 04:35 [entrez]
PHST- 2024/01/31 00:00 [pmc-release]
AID - tlcr-13-01-152 [pii]
AID - 10.21037/tlcr-23-798 [doi]
PST - ppublish
SO  - Transl Lung Cancer Res. 2024 Jan 31;13(1):152-162. doi: 10.21037/tlcr-23-798. 
      Epub 2024 Jan 22.