ArticleLung cancer (Amsterdam, Netherlands)2024
Real-world treatment sequencing and effectiveness of second- and third-generation ALK tyrosine kinase inhibitors for ALK-positive advanced non-small cell lung cancer.
Article in Lung cancer (Amsterdam, Netherlands), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Clinical characteristics of ALK-positive NSCLC patients treated with sequential ALK-TKI therapies in a single-centre.Lung cancer management · 2026Article
- Living WithJTO clinical and research reports · 2026Article
- US population-level model of clinical impact of lorlatinib treatment on ALK+ metastatic non-small cell lung cancer outcomes.Journal of comparative effectiveness research · 2026Article
- First Things First: Navigating ALK-Positive Metastatic Non-Small Cell Lung Cancer Treatment Options-A Podcast.Targeted oncology · 2026Article
- Lorlatinib-specific outcomes by timing of lorlatinib initiation in advanced ALK-positive non-small cell lung cancer: A retrospective cohort study.Therapeutic advances in medical oncology · 2026Article
- Long-Term Safety and Management of Adverse Events Associated With Lorlatinib inJournal of the advanced practitioner in oncology · 2025Article
- Lorlatinib in ALK-positive non-small cell lung cancer: final survival data that reshape the therapeutic landscape.Translational lung cancer research · 2025Article
- New advances in understanding the mechanisms and treatment challenges of ALK-targeted therapy resistance in lung cancer.Cancer drug resistance (Alhambra, Calif.) · 2025Review
Corrections and comments
- Erratum issued
Authors and funding
12 authors.
Funding
Abstract
introductionWith multiple targeted therapies approved for anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC), it is increasingly important to understand outcomes with various sequences of next-generation ALK tyrosine kinase inhibitors (TKIs). We describe contemporary sequencing patterns and treatment effectiveness of first-line (1L) and second-line (2L) treatments in patients who received second-generation ALK TKIs in the 1L treatment of ALK-positive NSCLC in the United States.
methodsA cohort of adults with ALK-positive advanced NSCLC who initiated treatment with 1L alectinib or brigatinib between June 2017 and April 2021 in the Flatiron Health electronic health record-derived de-identified database were followed through April 2023. Time to treatment discontinuation (TTD) in 1L and 2L, TTD on 1L plus 2L sequential therapy (TTD2), and total time on sequential ALK TKI therapy (including beyond 2L) were evaluated.
resultsPatients (N=273) were followed up for a median duration of 28.9 months. Among patients who discontinued 1L therapy, 22% died after 1L discontinuation (median time from discontinuation to death, 4.0 months) without receiving 2L therapy. Median (95% confidence interval [CI]) TTD was 21.9 (15.2-25.8) and 7.3 (5.3-10.2) months in 1L and 2L, respectively. Median (95% CI) TTD2 was 29.4 (25.1-36.1) months and total time on sequential ALK TKI treatment was 28.0 (23.6-32.9) months.
conclusionsIn this large real-world study, TTD2 and the total time on sequential ALK TKIs was approximately 2.5 years. The high attrition rate from 1L to 2L and the longest clinical benefit observed with 1L therapy support using the drug with the longest 1L effectiveness up front in patients with ALK-positive advanced NSCLC.
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