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Efficacy of Crizotinib for Advanced ALK-Rearranged Non-Small-Cell Lung Cancer Patients with Brain Metastasis: A Multicenter, Retrospective Study in China

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Abstract

Background

The efficacy of crizotinib for anaplastic lymphoma kinase (ALK)-rearranged non-small-cell lung cancer (NSCLC) patients with brain metastasis is controversial. Real-world research data are needed as further evidence.

Objective

We conducted a multicenter, retrospective study to explore how crizotinib affects the control of brain metastasis and the survival outcomes among Chinese patients.

Patients and Methods

We reviewed the medical records of unselected ALK-rearranged NSCLC patients treated with crizotinib at five hospitals in China from January 1, 2013 to November 30, 2017. Patients developing brain metastasis either before or during crizotinib treatment were included. Survival outcomes were analyzed by the Kaplan–Meier method, and prognostic factors were analyzed by multivariate Cox regression.

Results

A total of 174 patients were included in the analysis; 95 of these patients had baseline brain metastasis, while 79 patients developed brain metastasis during crizotinib treatment. Among patients with baseline brain metastasis, the median intracranial time to progression was 19.3 months (95% confidence interval [CI] 12.5–26.2) and the median overall survival (OS) was 53.4 months (95% CI not reached). A total of 135 patients experienced intracranial progression, and 94 of these patients continued crizotinib beyond progressive disease (CBPD). There was no significant difference in the median OS between patients with CBPD and without CBPD (48.3 months vs 53.4 months; p = 0.296).

Conclusions

ALK-rearranged advanced NSCLC patients with baseline brain metastasis can still achieve OS benefits from crizotinib treatment. However, patients with intracranial progression may not obtain a long-term survival benefit from continuation of CBPD.

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Author notes

  1. Puyuan Xing and Shouzheng Wang contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People’s Republic of China

    Puyuan Xing, Shouzheng Wang, Di Ma, Xuezhi Hao, Yan Wang & Junling Li

  2. Department of Pulmonary Medicine (Inpatient Area 1), Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, China

    Qiang Wang & Li Shan

  3. Department of Respiratory Medicine, Peking Union Medical College Hospital, Beijing, China

    Mengzhao Wang & Hongge Liang

  4. Department of Oncology, Second Affiliated Hospital of Harbin Medical University, Harbin, China

    Tao Xin & Yang Du

  5. Department of Tumor Chemotherapy and Radiation Sickness, Peking University Third Hospital, Beijing, China

    Li Liang & Zhaohui Zhang

Authors
  1. Puyuan Xing
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  2. Shouzheng Wang
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  3. Qiang Wang
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  4. Di Ma
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  5. Xuezhi Hao
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  6. Mengzhao Wang
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  7. Yan Wang
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  8. Li Shan
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  9. Tao Xin
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  10. Li Liang
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  11. Hongge Liang
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  12. Yang Du
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  13. Zhaohui Zhang
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  14. Junling Li
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Corresponding author

Correspondence to Junling Li.

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Funding

The study was funded by Pfizer investigator funding.

Conflict of interest

Junling Li has recived Pfizer investigator funding. Puyuan Xing, Shouzheng Wang, Qiang Wang, Di Ma, Xuezhi Hao, Mengzhao Wang, Yan Wang, Li Shan, Tao Xin, Li Liang, Hongge Liang, Yang Du, and Zhaohui Zhang declare that they have no conflicts of interest that might be relevant to the contents of this manuscript.

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Xing, P., Wang, S., Wang, Q. et al. Efficacy of Crizotinib for Advanced ALK-Rearranged Non-Small-Cell Lung Cancer Patients with Brain Metastasis: A Multicenter, Retrospective Study in China. Targ Oncol 14, 325–333 (2019). https://doi.org/10.1007/s11523-019-00637-5

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  • DOI: https://doi.org/10.1007/s11523-019-00637-5

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