title: Characteristics, treatment patterns, and survival among ALK+ non-small cell lung cancer (NSCLC) patients treated with crizotinib: A chart review study.
abstract: Second-generation ALK inhibitors are recently available for ALK+ non-small cell lung cancer (NSCLC) patients previously treated with crizotinib. This study described characteristics, treatment sequencing, and outcomes among locally advanced/metastatic crizotinib-experienced ALK+ NSCLC patients.
  
  
  
  From July 2014 to June 2015, a retrospective patient chart review was conducted among physicians from the US, EU, Korea, and Latin America. Participating clinicians identified their ALK+ NSCLC patients who received crizotinib and reported on their clinical characteristics, treatments, and survival using a pre-defined case report form. Kaplan-Meier analyses were used to describe overall survival (OS) and clinician-defined progression-free survival (PFS).
  
  
  
  Participating clinicians reviewed charts of 158 ALK+ NSCLC patients treated with crizotinib during the study period. Crizotinib was most commonly received in the second-line setting (41% of patients), though this varied across geographical regions. Roughly half (53%) of the patients who discontinued crizotinib received further antineoplastic therapy; second-generation ALK inhibitors (44%) and chemotherapy (42%) regimens were used most frequently. Following crizotinib discontinuation, median OS was 8.2 months. Among patients who did not initiate a second-generation ALK inhibitor following crizotinib, median OS was 4.9 months; among those who did, median OS was not reached. Among patients who received chemotherapy immediately following crizotinib discontinuation, time to clinician-defined PFS from post-crizotinib chemotherapy initiation was 3.6 months.
  
  
  
  Following crizotinib discontinuation, many patients received no further antineoplastic therapy, and OS was poor among patients who did not receive a second-generation ALK inhibitor. Recently available second-generation ALK inhibitors may provide important treatment options for ALK+ NSCLC patients.
authors.affiliation: Assistance Publique Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie Université Paris VI, Paris, France. Electronic address: jacques.cadranel@aphp.fr.
authors.forename: Jacques
authors.initials: J
authors.lastname: Cadranel
authors.affiliation: Samsung Medical Center Sungkyunkwan University School of Medicine, Innovative Cancer Medicine Institute Division of Hematology/Oncology, Seoul, Republic of Korea.
authors.forename: Keunchil
authors.initials: K
authors.lastname: Park
authors.affiliation: Instituto Nacional de Cancerología, Lung Cancer Department, Mexico City, Mexico.
authors.forename: Oscar
authors.initials: O
authors.lastname: Arrieta
authors.affiliation: Kantonsspital Winterthur, Departement Medizin Medizinische Onkologie, Winterthur, Switzerland.
authors.forename: Miklos
authors.initials: M
authors.lastname: Pless
authors.affiliation: Marion General Hospital, Medical Oncology, Marion, USA.
authors.forename: Edmond
authors.initials: E
authors.lastname: Bendaly
authors.affiliation: Navigant Consulting Inc., Life Sciences, London, United Kingdom.
authors.forename: Dony
authors.initials: D
authors.lastname: Patel
authors.affiliation: Novartis Pharmaceuticals Corporation, East Hanover, USA.
authors.forename: Medha
authors.initials: M
authors.lastname: Sasane
authors.affiliation: Novartis Farma S.p.A., Pricing/Health Economics & Access: Oncology Region Europe, Origgio, Italy.
authors.forename: Adam
authors.initials: A
authors.lastname: Nosal
authors.affiliation: Analysis Group Inc., Health Economics and Outcomes Research, Boston, USA.
authors.forename: Elyse
authors.initials: E
authors.lastname: Swallow
authors.affiliation: Analysis Group Inc., Health Economics and Outcomes Research, Boston, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Galebach
authors.affiliation: Analysis Group Inc., Health Economics and Outcomes Research, Boston, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Kageleiry
authors.affiliation: Novartis Pharmaceuticals Corporation, East Hanover, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Stein
authors.affiliation: Navigant Consulting Inc., Life Sciences, London, United Kingdom.
authors.forename: Ravi
authors.initials: R
authors.lastname: Degun
authors.affiliation: Novartis Pharmaceuticals Corporation, East Hanover, USA.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000077548:Anaplastic Lymphoma Kinase; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality; D000077547:Crizotinib; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians'; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011720:Pyrazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011725:Pyridines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D020794:Receptor Protein-Tyrosine Kinases / Q000378:metabolism; D019233:Retreatment; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D047428:Protein Kinase Inhibitors; D011720:Pyrazoles; D011725:Pyridines; D000077547:Crizotinib; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases
keywords: Anaplastic lymphoma kinase; Carcinoma; Lung neoplasms; Non-small-cell lung; Protein kinase inhibitor; Survival