- Platinum/pemetrexed-based chemotherapy yielded modest efficacy in patients with anaplastic lymphoma kinase (ALK)-positive NSCLC refractory to ≥1 second-generation ALK tyrosine kinase inhibitors (TKIs).
- The efficacy was better in patients who received the combination chemotherapy with an ALK TKI.
Why this matters
- The most effective next-line therapy after failure of a second-generation ALK TKI is unknown.
- 58 patients with advanced ALK-positive NSCLC refractory to ≥1 second-generation ALK TKI(s) received platinum/pemetrexed-based chemotherapy (PT/pem-based chemotherapy).
- Funding: National Cancer Institute and others.
- 88% of patients had ≥2 prior ALK TKIs, and 21% had ≥3 prior ALK TKIs.
- 95% received PT/pem-based chemotherapy immediately following a second-generation ALK inhibitor.
- Objective response rate (ORR) was 29.7% (95% CI, 15.9%-47.0%) and central nervous system ORR was 15.8% (95% CI, 3.4%-39.6%).
- Median overall PFS on PT/pem-based chemotherapy for the entire cohort was 4.3 (95% CI, 2.9-5.8) months.
- Risk of intracranial progression at 1 year was 30% (95% CI, 18%-44%).
- Receipt of any PT/pem-based combination chemotherapy plus an ALK TKI was associated with significantly better median PFS compared with PT/pem-based chemotherapy alone (7.7 vs 3.6 months; HR, 0.31; P=.002).
- Retrospective study.