NSCLC: delaying ALK inhibitor treatment raises death risk

  • Lung Cancer

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients with anaplastic lymphoma kinase-positive (ALK+) advanced NSCLC who delay treatment with ALK inhibitors have a significantly higher mortality risk.
  • Receipt of chemotherapy, either before or after ALK inhibitor therapy, offers no survival benefit.

Why this matters

  • The findings suggest that ALK+ patients ages ≥65 years and those who received chemotherapy before ALK+ test results are more likely to delay ALK inhibitor treatment, increasing risk for death.

Study design

  • 442 patients with ALK+ advanced NSCLC began treatment with an ALK inhibitor within 3 weeks of ALK+ test results (early use; n=257) or >3 weeks later (delayed use; n=185).
  • Funding: Genentech, Inc.

Key results

  • Patients ≥65 years were significantly more likely to be untreated at 3 weeks after ALK+ diagnosis:
    • 65-74 years: aHR, 0.60 (95% CI, 0.44-0.83). 
    • ≥75 years: aHR, 0.65 (95% CI, 0.46-0.92).
  • Receipt of chemotherapy before ALK inhibitor therapy was associated with delayed treatment:
    • aHR, 0.74 (95% CI, 0.55-1.00).
  • Delaying initiation of ALK inhibitors was associated with a significantly higher risk for mortality:
    • aHR, 2.05 (95% CI, 1.13-3.71.
  • No survival benefit from receiving chemotherapy before or after ALK inhibitor therapy.

Limitations

  • Retrospective study.