Guérin Annie, Sasane Medha, Zhang Jie, Macalalad Alexander R, Galebach Philip, Jarvis John, Kageleiry Andrew, Culver Kenneth, Wu Eric Q, Wakelee Heather
Group d'analyse, Ltée, Montréal, Quebec, Canada.
Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
Cancer Epidemiol. 2015 Jun;39(3):307-12. doi: 10.1016/j.canep.2015.04.005. Epub 2015 Apr 23.
Approximately 2-8% of non-small cell lung cancer (NSCLC) patients have rearrangements in the anaplastic lymphoma kinase gene (ALK). ALK-targeted therapy is available to patients with tumors known to be ALK+. This chart review study described characteristics of patients with ALK+ NSCLC, patterns of ALK testing and subsequent treatments, and oncologists' experience with ALK testing in the US.
US oncologists provided information in September and October of 2013 on patients from their practice diagnosed with ALK+ locally advanced or metastatic NSCLC, including the timing of ALK testing and treatment received after testing. Participating oncologists were also surveyed about their experience with ALK testing.
27 oncologists provided data on 273 ALK+ NSCLC patients. Patients' median age was 67 years upon NSCLC diagnosis. Smoking history varied, with 33% nonsmokers, 33% light smokers, and 33% heavy smokers. Patients were racially diverse: 59% White, 18% Black, 13% Asian, and 10% other. Upon diagnosis of advanced/metastatic NSCLC, patients who were either not tested (19%) or initially tested negative/inconclusive (1%) all received first-line chemotherapy; the other 219 patients (80%) tested positive, with 133 (61%) receiving an ALK inhibitor and 78 (29%) receiving chemotherapy as first-line treatment. Many oncologists stated being more likely to test for ALK rearrangements among Asians, nonsmokers, and light smokers.
In this sample, ALK+ NSCLC patients were racially diverse with mixed smoking history. One in five patients were not tested before first-line therapy. Oncologists reported being more likely to consider ALK testing for patients with particular smoking and race characteristics.
约2%-8%的非小细胞肺癌（NSCLC）患者间变性淋巴瘤激酶基因（ALK）存在重排。已知肿瘤为ALK阳性的患者可接受ALK靶向治疗。本图表回顾性研究描述了ALK阳性NSCLC患者的特征、ALK检测模式及后续治疗情况，以及美国肿瘤学家进行ALK检测的经验。
美国肿瘤学家于2013年9月和10月提供了其诊所中诊断为ALK阳性的局部晚期或转移性NSCLC患者的信息，包括ALK检测时间及检测后接受的治疗。参与研究的肿瘤学家还被调查了他们进行ALK检测的经验。
27位肿瘤学家提供了273例ALK阳性NSCLC患者的数据。NSCLC诊断时患者的中位年龄为67岁。吸烟史各不相同，33%为不吸烟者，33%为轻度吸烟者，33%为重度吸烟者。患者种族多样：59%为白人，18%为黑人，13%为亚洲人，10%为其他种族。在诊断为晚期/转移性NSCLC时，未进行检测的患者（19%）或最初检测为阴性/不确定的患者（1%）均接受了一线化疗；其他219例患者（80%）检测为阳性，其中133例（61%）接受了ALK抑制剂治疗，78例（29%）接受了化疗作为一线治疗。许多肿瘤学家表示，在亚洲人、不吸烟者和轻度吸烟者中更有可能检测ALK重排。
在该样本中，ALK阳性NSCLC患者种族多样，吸烟史各异。五分之一的患者在一线治疗前未进行检测。肿瘤学家报告称，对于具有特定吸烟和种族特征的患者更有可能考虑进行ALK检测。
