Distinct metastatic spread and progression patterns in patients treated with crizotinib for - and -rearranged non-small cell lung cancer: a single-center retrospective study.

BACKGROUND

Crizotinib has been approved for C-ros oncogene 1 (- and anaplastic lymphoma kinase -rearranged non-small cell lung cancer (NSCLC) patients. Few studies have examined the differences in crizotinib treatment outcomes between these patients and the progression sites during treatment. We investigated the metastatic spread, crizotinib efficacy, and progression patterns during crizotinib treatment in - and rearranged NSCLC patients.

METHODS

We retrospectively reviewed crizotinib-treated - and -rearranged NSCLC patients between January 2011 and March 2021. Patient characteristics, clinical outcomes, and progression patterns during treatment were collected from medical records. The metastasis extent, crizotinib response, and progression patterns between the groups were compared.

RESULTS

We identified 26 patients with - and 42 with -positive NSCLC. The baseline proportion of central nervous system (CNS) metastases did not differ between the groups (12% 29%, P=0.10), but the proportion of extrathoracic metastases, including CNS metastases, was significantly higher in -positive than in -positive NSCLC patients (35% 71%, P=0.003). Regarding the response to crizotinib, the objective response rate (ORR), progression-free survival (PFS), or overall survival (OS) did not significantly differ between the groups ( , ORR: 69% 69%, P=0.987; PFS: median 10.9 10.7 months, P=0.232; median OS: not reached 67.7 months, P=0.495). The CNS was the most common metastasis site in both groups [ , 69% (11/16) 46% (17/37), P=0.127], and the cumulative incidence of CNS metastasis did not differ between the groups (P=0.914).

CONCLUSIONS

Crizotinib treatment outcomes, including progression patterns, were similar between - and -positive NSCLC patients.