Oya Yuko, Yoshida Tatsuya, Kuroda Hiroaki, Shimizu Junichi, Horio Yoshitsugu, Sakao Yukinori, Hida Toyoaki, Yatabe Yasushi
Department of Thoracic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.
Department of Thoracic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
Anticancer Res. 2017 Nov;37(11):6477-6480. doi: 10.21873/anticanres.12103.
Several second-generation inhibitors of anaplastic lymphoma kinase (ALK) have demonstrated potent activity in ALK rearrangement-positive non-small cell lung cancer (NSCLC). Two of these agents, ceritinib, and alectinib, recently received approval for the treatment of ALK-rearranged NSCLC in Japan. The efficacy of treatment with a second-generation ALK inhibitor after failure with a different second-generation ALK inhibitor remains unclear. We present a series of eight patients with ALK-rearranged NSCLC treated with alectinib who experienced disease progression after ceritinib. Both crizotinib and ceritinib were administered to six patients, with four (29%) patients receiving crizotinib followed by ceritinib. Among the eight study patients, two (25%) had partial response, one (12%) stable disease, and five (63%) had progressive disease. The median progression-free survival was 3.6 months (95% confidence interval=0-7.1 months). The results of this study suggest that the second-generation ALK inhibitor alectinib has limited efficacy after initial treatment with the second-generation ALK inhibitor ceritinib.
几种第二代间变性淋巴瘤激酶（ALK）抑制剂已在ALK重排阳性非小细胞肺癌（NSCLC）中显示出强效活性。其中两种药物，色瑞替尼和阿来替尼，最近在日本获得了用于治疗ALK重排NSCLC的批准。在使用不同的第二代ALK抑制剂治疗失败后，使用第二代ALK抑制剂治疗的疗效仍不清楚。我们报告了一组8例ALK重排NSCLC患者，他们在接受色瑞替尼治疗后疾病进展，随后接受了阿来替尼治疗。6例患者同时接受了克唑替尼和色瑞替尼治疗，其中4例（29%）患者先接受克唑替尼治疗，随后接受色瑞替尼治疗。在这8例研究患者中，2例（25%）出现部分缓解，1例（12%）病情稳定，5例（63%）病情进展。无进展生存期的中位数为3.6个月（95%置信区间=0-7.1个月）。本研究结果表明，在初始使用第二代ALK抑制剂色瑞替尼治疗后，第二代ALK抑制剂阿来替尼的疗效有限。
