Wu Yi-Long, Lu Shun, Yang James Chih-Hsin, Zhou Jianying, Seto Takashi, Ahn Myung-Ju, Su Wu-Chou, Yamamoto Noboru, Kim Dong-Wan, Paolini Jolanda, Usari Tiziana, Iadeluca Laura, Wilner Keith D, Goto Koichi
Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.
Jiao Tong University, Shanghai, People's Republic of China.
JTO Clin Res Rep. 2022 Sep 9;3(10):100406. doi: 10.1016/j.jtocrr.2022.100406. eCollection 2022 Oct.
Crizotinib provided meaningful clinical benefit in the initial analysis of a phase 2 study in East Asian patients with advanced -positive NSCLC (NCT01945021). Nevertheless, overall survival (OS) data were immature. Here, we present the final OS, quality of life (QoL), and safety data after an additional 3 years of follow-up.
In this phase 2, open-label, single-arm trial, East Asian patients with -positive advanced NSCLC who had received less than or equal to three systemic therapies previously were treated with crizotinib 250 mg twice daily on a continuous daily dosing schedule in 28-day cycles. The OS (secondary end point) was analyzed for the total population, by country, and by number of previous chemotherapy regimens. QoL and safety were also evaluated.
With a median duration of follow-up of 56.1 months, the median OS was 44.2 months (95% confidence interval: 32.0-not reached) for the total population (N = 127). Differences in median OS were observed among individual countries and with number of previous regimens. The improvement in QoL found in the previous analysis was maintained with the extended follow-up. Treatment-related adverse events led to crizotinib dose reductions or permanent treatment discontinuations in 17.3% and 2.4%, respectively, of the patients.
This is the largest trial of an ALK/ROS1 inhibitor to treat patients with -positive advanced NSCLC and provides a new benchmark for OS in East Asian patients. The QoL and safety profile with long-term follow-up were consistent with previous reports and support the continued use of crizotinib in the treatment of patients with -positive advanced NSCLC.
在一项针对东亚晚期ALK阳性非小细胞肺癌患者的2期研究(NCT01945021)的初始分析中,克唑替尼显示出有意义的临床获益。然而,总生存期(OS)数据并不成熟。在此,我们呈现了额外3年随访后的最终OS、生活质量(QoL)和安全性数据。
在这项2期、开放标签、单臂试验中,既往接受过少于或等于三种全身治疗的东亚ALK阳性晚期非小细胞肺癌患者,接受克唑替尼250mg每日两次,采用连续每日给药方案,每28天为一个周期。对总人群、按国家以及按既往化疗方案数量分析OS(次要终点)。还评估了QoL和安全性。
中位随访时间为56.1个月,总人群(N = 127)的中位OS为44.2个月(95%置信区间:32.0 - 未达到)。在各个国家以及既往治疗方案数量之间观察到了中位OS的差异。先前分析中发现的QoL改善在延长随访后得以维持。治疗相关不良事件分别导致17.3%和2.4%的患者克唑替尼剂量减少或永久停药。
这是治疗ALK阳性晚期非小细胞肺癌患者的ALK/ROS1抑制剂的最大规模试验,并为东亚患者的OS提供了新的基准。长期随访的QoL和安全性概况与先前报告一致,并支持继续使用克唑替尼治疗ALK阳性晚期非小细胞肺癌患者。