Meta-analysis: pneumonitis rare in ALK-positive NSCLC

  • Lung Cancer

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • 2.14% of patients with anaplastic lymphoma kinase (ALK)-positive advanced NSCLC developed ALK inhibitor-related pneumonitis, according to a meta-analysis that also found patients in Japan had a higher incidence of ALK pneumonitis compared with patients from other countries.
  • Patients treated with brigatinib had the highest incidence of pneumonitis compared with those treated with other ALK inhibitors.

Why this matters

  • NSCLC with ALK rearrangement is rare, accounting for only about 5% of all NSCLC cases, so data on ALK pneumonitis were lacking.

Study design

  • Meta-analysis of 18 studies involving 2261 patients treated with ALK inhibitor monotherapy for advanced NSCLC.
  • Funding: None disclosed.

Key results

  • Overall pooled incidence of pneumonitis was 2.14% for all-grade, 1.33% for high-grade, 0.22% for grade-5.
  • Patients treated with brigatinib had the highest incidence of all-grade pneumonitis at 4.11% (aOR, 4.827; P=.007).
  • Pneumonitis incidence was significantly higher in studies from Japan than in those from other countries for all-grade (6.25% vs 1.14%; P<.001 and high-grade pneumonitis vs p>
  • After multivariable analysis, cohorts from Japanese studies had significantly higher risk of all-grade pneumonitis than cohorts from other countries (OR, 4.329; P<.001>

Limitations

  • Only 20 cohorts included in meta-analysis.
  • No patient-level data.

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