Wei Jingwen, Sun Wei, Zeng Xiaohong, Zhou Huan, Song Zhengbo
Postgraduate Training Base Alliance of Wenzhou Medical University (Zhejiang Cancer Hospital), Hangzhou, China.
Department of Clinical Trial, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
J Thorac Dis. 2024 Jul 30;16(7):4146-4154. doi: 10.21037/jtd-24-7. Epub 2024 Jul 22.
Anaplastic lymphoma kinase ()-rearranged pulmonary squamous cell carcinoma (SCC) is a rare subtype of non-small cell lung cancer and the treatment options are limited. We aimed to evaluate the efficacy of tyrosine kinase inhibitors (TKIs) in advanced lung SCC patients with rearrangement.
We collected 11 primary lung SCC samples at the Zhejiang Cancer Hospital between March 2015 and October 2022. In addition, we conducted a literature search of previous studies, and a pooled analysis of 34 patients was performed. The Kaplan-Meier method was applied to generate progression-free survival (PFS) and overall survival (OS) curves, and a log-rank test was used to compare PFS and OS curves for different subgroups.
A pooled analysis of 36 patients was performed. Nineteen patients (52.8%) achieved partial response and 9 (25.0%) had stable disease. The objective response rate was 52.8%, and the disease control rate was 77.8%. The median PFS was 7.10 months. Further, alectinib was not superior to crizotinib in prolonging PFS (9.00 . 6.00 months, P=0.60). The median PFS of patients receiving initial ALK TKIs as the first-line therapy and second- or further-line therapy was 9.00 and 6.00 months (P=0.26), respectively.
Patients with -rearranged lung SCC obtained moderate benefit from -inhibitor therapy. Compared with crizotinib, alectinib did not show superior efficacy in the treatment of -positive lung SCC. Further high-quality trials are warranted.
间变性淋巴瘤激酶（ALK）重排的肺鳞状细胞癌（SCC）是一种罕见的非小细胞肺癌亚型，治疗选择有限。我们旨在评估ALK酪氨酸激酶抑制剂（TKIs）对晚期肺SCC伴ALK重排患者的疗效。
我们于2015年3月至2022年10月在浙江省肿瘤医院收集了11例原发性肺SCC样本。此外，我们对先前的研究进行了文献检索，并对34例患者进行了汇总分析。采用Kaplan-Meier法生成无进展生存期（PFS）和总生存期（OS）曲线，并使用对数秩检验比较不同亚组的PFS和OS曲线。
对36例患者进行了汇总分析。19例患者（52.8%）获得部分缓解，9例（25.0%）病情稳定。客观缓解率为52.8%，疾病控制率为77.8%。中位PFS为7.10个月。此外，在延长PFS方面，阿来替尼并不优于克唑替尼（9.00对6.00个月，P=0.60）。接受初始ALK TKIs作为一线治疗和二线或后续治疗的患者的中位PFS分别为9.00和6.00个月（P=0.26）。
ALK重排的肺SCC患者从ALK抑制剂治疗中获得了中度益处。与克唑替尼相比，阿来替尼在治疗ALK阳性肺SCC方面未显示出更优的疗效。需要进一步开展高质量试验。
