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CC BY-NC-ND 4.0 · South Asian J Cancer 2023; 12(02): 179-184
DOI: 10.1055/s-0042-1753478
Original Article
Lung Cancer

Long-Term Outcomes of Crizotinib Treated ALK-Positive Lung Cancer Patients: A Retrospective Audit of Prospective Data from Resource-Constrained Settings

Akhil Kapoor 
1   Department of Medical Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Center and Homi Bhabha Cancer Hospital (A Unit of Tata Memorial Center, Mumbai), Varanasi, Uttar Pradesh, India
,
Vanita Noronha
2   Department of Medical Oncology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
,
Vijay Patil
2   Department of Medical Oncology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
,
Nandini Menon 
2   Department of Medical Oncology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
,
Ravindra Nandhana
2   Department of Medical Oncology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
,
Amit Kumar
3   Department of Medical Oncology, Homi Bhabha Cancer Hospital, Muzaffarpur, and Jay Prabha Medanta Hospital, Patna, Bihar, India
,
Abhishek Mahajan 
4   Department of Radiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Amit Janu
4   Department of Radiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Rajiv Kumar
5   Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Kumar Prabhash
2   Department of Medical Oncology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
› Author Affiliations Funding None.
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Abstract

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Akhil Kapoor

Purpose Crizotinib has been one of the standard treatment options for the treatment of anaplastic lymphoma kinase (ALK) rearranged non-small cell lung cancer (NSCLC) based on higher progression-free survival (PFS) and objective response rates in phase III clinical trials. However, real-world data about the long-term efficacy and toxicity of crizotinib is limited.

Methods A retrospective analysis of all patients with ALK-positive NSCLC, treated with crizotinib between March 2014 and December 2016, was performed. The main outcomes measured were PFS, overall survival (OS), and adverse effects.

Results One hundred and eighty-eight patients treated with crizotinib during this period were included in this study. The median age was 50 years (range: 24–74) with a majority being males (73.2%) and 80.3% with a performance status of 0 to 1. The median duration of follow-up was 49.4 months (range: 3.4–86.3%). The median PFS of crizotinib was 17.3 months (95% confidence interval [CI], 13.0–21.6) and 12.8 months (95% CI, 8.1–17.6) when used in first line or subsequent lines, respectively. The median OS was 38.3 months (95% CI, 28.4–48.2). The patients who received crizotinib in the first line had a median OS of 45.5 months (95% CI, 29.6–61.4) as compared with 29.7 months (95% CI, 22.2–37.2) for those who received in subsequent line (hazard ratio, 0.6, 95% CI, 0.4–0.9, p=0.022). The most common all grade toxicities include transaminitis, anemia, fatigue, and corrected QT prolongation.

Conclusion This real-world study confirms the long-term beneficial effects of crizotinib in ALK rearranged NSCLC with favorable toxicity profile like that of the registration studies, in resource constrained settings.

Keywords

crizotinib - ALK-positive - lung cancer - long-term outcomes

Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.




Publication History

Article published online:
02 September 2022

© 2022. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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