Davies, Jessica Martinec, Michael Coudert, Mathieu Delmar, Paul Crane, Gracy Real-world anaplastic lymphoma kinase (ALK) rearrangement testing patterns, treatment sequences, and survival of ALK inhibitor-treated patients <p><b>Background:</b> The anaplastic lymphoma kinase (ALK) treatment landscape is crowded following recent ALK inhibitor approvals, and updated information on real-world treatment patterns in advanced non-small-cell lung cancer (aNSCLC) with ALK rearrangement (<i>ALK+</i>) is needed.</p> <p><b>Methods:</b> This retrospective US cohort study used Flatiron Health’s longitudinal electronic health record (EHR)-derived database. Patients (≥ 18 years old) diagnosed with stage IIIB/IV aNSCLC, with documented <i>ALK</i> rearrangement and ≥2 visits after January 1, 2011 were followed until February 28, 2016. Patients enrolled on a clinical trial or exposed to ALK inhibitors other than crizotinib or ceritinib were excluded. Treatment patterns, time and type of biomarker testing, and overall survival (OS) were analyzed.</p> <p><b>Results:</b> Median age (<i>n</i> = 300) was 62.5 years; 55% female; 48% non-smokers; 8.7% central nervous system (CNS) metastases at diagnosis. Overall, 73% and 86% received their first <i>ALK</i> biomarker test before/at diagnosis, or before/during first-line treatment, respectively. In total, 90.0%, 78.1%, and 74.7% received first-, second-, and third-line therapy, respectively. Most patients received ALK-targeted treatment; 62% received crizotinib, of which 21% reported a dose reduction. Progression was the most common reason for crizotinib (78%) and ceritinib (41%) discontinuation. Median OS was 29.4 months (95% CI =24.7–39.6) overall; 27.1 months (95% CI =22.0–35.0) in patients with CNS metastases, and 36.9 months (95% CI =25.1–not reached) without.</p> <p><b>Conclusions:</b> Despite widespread crizotinib use in patients with <i>ALK</i>+ aNSCLC, a high proportion of patients progressed. Ongoing analyses of EHR-derived cohorts are valuable in assessing real-world testing rates and therapeutic use of ALK inhibitors.</p> ALK positive;NSCLC;Real-world data;Flatiron;Treatment sequence 2018-11-09
    https://tandf.figshare.com/articles/journal_contribution/Real-world_anaplastic_lymphoma_kinase_i_ALK_i_rearrangement_testing_patterns_treatment_sequences_and_survival_of_ALK_inhibitor-treated_patients/7178894
10.6084/m9.figshare.7178894.v2