Effects of Treatment with Crizotinib on Non-small Cell Lung Carcinoma with ALK Translocation in the Czech Republic
Authors:
Pešek Miloš 1; Skřičková Jana 2; Kolek Vítězslav 3; Šatánková Monika 2; Koubková Leona 4; Roubec Jaromír 5; Chloupková Renata 6; Černovská Markéta 7; Benejová Andrea 2; Kultan Juraj 3; Hrnčiarik Michal 8; Zemanová Milada 9; Konečný Marek 6; Čoupková Helena 10; Svatoň Martin 1
Authors‘ workplace:
Klinika pneumologie a ftizeologie, LF UK a FN Plzeň
1; Klinika nemocí plicních a tuberkulózy LF MU a FN Brno
2; Klinika nemocí plicních a tuberkulózy LF UP a FN Olomouc
3; Pneumologická klinika 2. LF UK a FN Motol, Praha
4; Klinika plicních nemocí a tuberkulózy LF OU a FN Ostrava
5; Institut biostatistiky a analýz, LF MU, Brno
6; Pneumologická klinika 1. LF UK a Thomayerova nemocnice, Praha
7; Plicní klinika LF UK a FN Hradec Králové
8; Onkologická klinika 1. LF UK a VFN v Praze
9; Klinika komplexní onkologické péče, MOU, Brno
10
Published in:
Klin Onkol 2018; 31(3): 207-212
Category:
Original Articles
doi:
https://doi.org/10.14735/amko2018207
Overview
Background:
Patients with advanced anaplastic lymphoma kinase (ALK) -positive non-small cell lung cancer (NSCLC) may gain significant benefit from treatment with the first-generation ALK inhibitor crizotinib. This study investigated the effects of crizotinib in advanced ALK-positive NSCLC patients via analyzing data submitted to the TULUNG registry by pneumo-oncology centers in the Czech Republic.
Patients and methods:
We analyzed the data of 60 NSCLC patients submitted to the TULUNG registry by pneumo-oncology centers who had ALK translocation confirmed by fluorescence in situ hybridization and complete data records from 2011 to 2017.
Results:
The median age of patients was 58 years. A total of 53% of patients were men, 90% had adenocarcinomas, 61.7% were smokers or ex-smokers, and 65% had a performance status of 0. Upon initiation of crizotinib therapy, most patients were at stage IV (88.3%) and the remainder were at stage IIIA or IIIB. Crizotinib was the second-line therapy in 71.7% of patients. A total of 20% of patients suffered side effects, while 11.7% suffered grade 3 and 4 adverse effects. A total of, 6.7, 25, 21.7, and 25% of patients displayed a complete response, a partial response, stable disease, and progressive disease, resp. Progression-free survival (PFS) was 5.8 months. Overall survival (OS) was 27.9 months from the initiation of the first-line therapy and 12.6 from the initiation of crizotinib therapy. PFS and OS were longer among nonsmokers and ex-smokers than among smokers (PFS, 9.7 vs. 5.8 vs. 3.8 months, p = 0.029; OS, 26.8 vs. 15.3 vs. 7.0 months, p = 0.015).
Conclusion:
Targeted crizotinib therapy is well tolerated and has significant benefit in patients with advanced ALK-positive NSCLC. Although international guidelines recommend that crizotinib is only used as a first-line therapy, it is used as a second-line and higher-line therapy in the Czech Republic. Clinical studies provide evidence that targeted therapy elicits better effects and less toxicity than routine chemotherapy.
Key words:
ALK translocation – crizotinib – targeted biological therapy – tyrosine kinase inhibitors
This work was supported by AZV grant No. 17- 30748A.
The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.
The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.
Submitted: 17. 1. 2018
Accepted: 20. 2. 2018
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